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Reliability of a Skin Diagnostic Device in Assessing Hydration and Erythema

Huimin, Koh BN (Hons), RN; Rowledge, Alexandra M. BAppSci, MPodPrac; Borzdynski, Caroline J. BN (Hons), RN; Miller, Charne BA (Hons), GDip (Stat); Frescos, Nicoletta BAppSci (Podiatry), MPH; McKenzie, Gayle MEd, GDip Adv Nurs (Crit Care), GCert Adv Nurs (Clin Ed), BSocSc, RN; Perry, Elizabeth BAppSci (Podiatry), Postgrad Dip Gerontology; McGuiness, William PhD, RN

doi: 10.1097/01.ASW.0000520117.58976.32
Features: Original Investigation

OBJECTIVE: To examine the reliability of a skin diagnostic device, the SD202 (Courage+Khazaka GmBH, Cologne, Germany), in assessing hydration and erythema of periwound skin and pressure injury-prone areas.

DESIGN: Intrarater reliabilities from 3 cross-sectional and prospective studies are reported.

SETTING AND PARTICIPANTS: Patients attending an outpatient, nurse-led wound dressing clinic (n = 16), a podiatrist-led high-risk foot clinic (n = 17), and residents (n = 38) at a single residential aged-care facility.

MAIN OUTCOME MEASURE: Skin hydration and erythema levels assessed using the SD202.

MAIN RESULTS: High internal consistency was maintained for consecutive skin hydration and erythema measures at a single point on the venous leg ulcer periwound (α > .996 and α > .970 for hydration and erythema, respectively) and for the pressure-prone areas of the sacrum (α > .916), right (α > .994) and left (α > .967) ischium, right (α > .989) and left (α > .916) trochanter, right (α > .985) and left (α > .992) calcaneus, and right (α > .991) and left (α > .990) lateral malleolus. High consistency was also found for the measures obtained at 4 different locations around the periwound for the venous leg ulcer (α > .935 and α > .870 for hydration and erythema, respectively). In diabetic foot ulcer assessment, acceptable internal consistency of hydration measures around the periwound was observed (α > .634). Internal consistency of erythema measures was variable, ranging from low to high reliability, particularly among predebridement measures.

CONCLUSIONS: Using the protocols outlined in this study, the SD202 demonstrates high reliability for assessing skin hydration and erythema levels. It is possible that the SD202 can be used in clinical practice as an appropriate tool for skin hydration and erythema assessment.

Koh Huimin, BN (Hons), RN, is a Nurse, National University Polyclinics, Singapore. Alexandra M. Rowledge, BAppSci, MPodPrac, is a Podiatrist, St. Vincent’s Hospital; Caroline J. Borzdynski, BN (Hons), RN, is a PhD candidate, La Trobe University; Charne Miller, PhD, is a Senior Lecturer, La Trobe University; Nicoletta Frescos, BAppSci (Podiatry), MPH, is a Lecturer, Department of Podiatry, La Trobe University; Gayle McKenzie, MEd, GDip Adv Nurs (Crit Care), GCert Adv Nurs (Clin Ed), BSocSc, RN, is a Lecturer, La Trobe University; Elizabeth Perry, BAppSci (Podiatry), Postgrad Dip Gerontology, is Podiatry Chief Advisor, Alfred Health; and William McGuiness, PhD, RN, is a Director, LaTrobe Alfred Clinical School, La Trobe University; all in Victoria, Australia.

The authors have disclosed that they have no financial relationships related to this article.

Submitted March 16, 2015; accepted in revised form November 12, 2015.

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