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Using Alternative Light Source Technology to Enhance Visual Inspection of the Skin

Owens, Lisa; Warfield, Tonnie; MacDonald, Ryan; Krenzischek, Erudina

Journal of Wound Ostomy & Continence Nursing: July/August 2018 - Volume 45 - Issue 4 - p 356–358
doi: 10.1097/WON.0000000000000448
Challenges in Practice

BACKGROUND: The identification of deep tissue pressure injury (DTPI) in the early stages of evolution presents a challenge, as skin compromise is only visually apparent when evidence of damage reaches its outer layers.

CASE DESCRIPTION: We describe use of an alternative light source (ALS) to enhance visual skin assessment in 3 cases. Case 1 was a 47-year-old African American man with a hyperpigmented inner buttocks and a mixture of partial- and shallow full-thickness skin loss from incontinence-associated dermatitis and friction. Case 2 was a 62-year-old African American woman with a gluteal cleft DTPI. Case 3 was a 57-year-old African American woman with a stage 3 pressure injury of the right buttock.

CONCLUSION: The ALS enabled visualization of skin nuances not visible to the unaided eye. Based on this experience, we conclude that use of an ALS provided additional visual details when compared to traditional visual inspection. We found that as the ALS interplays with skin layers, penetrating and absorbing at differing depths, compromised skin appeared darker and more distinct when compared to adjacent, intact skin. Additional research is needed to determine whether the ALS enables earlier pressure injury detection, timelier and more effective intervention, decreased morbidity, and cost savings.

Lisa Owens, MSN, RN-BC, CWOCN, Mercy Medical Center, Baltimore, Maryland.

Tonnie Warfield, BSN, RN, CWOCN, CFCN, Mercy Medical Center, Baltimore, Maryland.

Ryan MacDonald, PhD, Mercy Medical Center, Baltimore, Maryland.

Erudina Krenzischek, PhD, RN, CPAN, FAAN, Mercy Medical Center, Baltimore, Maryland.

Correspondence: Lisa Owens, MSN, RN-BC, CWOCN, Mercy Medical Center, 301 St Paul Pl, Bunting 12, Baltimore, MD 21202 (

The authors declare no conflicts of interest.

© 2018 by the Wound, Ostomy and Continence Nurses Society.