Sub-Epidermal Moisture and the Role of Inflammation in Pressure Injury Development

června, 08 2021

Pressure injuries (PI) (also known as pressure ulcers), are a major health care problem occurring across all healthcare settings¹.

Costs of pressure injuries

Pressure injuries cost $9.1-$11.6 billion per year in the US. Cost of individual patient care ranges from $20,900 to $151,700 per pressure injury. In 2007 it was estimated that each pressure injury added $43,180 in costs to a hospital stay.¹ More than 17,000 lawsuits are related to pressure injuries annually, and it is the second most common claim after wrongful death, and greater than falls or emotional distress.¹  


Hospital Acquired Conditions have decreased by 13%, but pressure injuries increased by 6%

While there was a decline in all Hospital Acquired Conditions (HAC), pressure injuries are the only HAC increasing (+6%), accounting for 27% of all HACs in 2017.⁵


Length of hospital stay doubles when a patient has a pressure injury

While the length of stay for all other conditions is about 5 days, it can be a lot longer with a pressure injury.¹ When a person is diagnosed with a pressure injury, the length of stay is about 12.7 days, representing slightly more than double.¹


Set a new standard of clinical excellence

Because pressure injury care is multifaceted and complex, efforts to improve prevention require a system approach and a multi-component solution that might involve organisational change. We can support you in elevating the pressure injury pathway in your care environment by ensuring early and targeted risk assessment, delivering the appropriate intervention for your vulnerable patients, and driving clinical excellence and best practice.

Arjo Early and Targeted Intervention Kit (ETIK)

The Arjo Pressure Injury Prevention Solution empowers you with the ability to elevate the pressure injury prevention pathway in your care environment, equipping you with the knowledge, skills and tools to act on a new standard of clinical excellence and deliver measurable outcomes in the early identification, prevention and management of pressure injuries.

This is achieved through a multi-component intervention kit that includes:


The Provizio® SEM Scanner is a handheld, wireless objective  medical device that uses biocapacitance to identify increased risk of PI and gives insight to the clinician that a patient without visible external signs of tissue damage is at risk of PI development on the heel or sacrum.  The Provizio®  SEM Scanner has been demonstrated as an effective tool supporting the prevention of PI when used as an adjunct to standard of care with a weighted average reduction in PI incidence of 90.5% in acute care facilities13.  Economic modelling studies based on a conservative range of assumptions also suggest that the implementation of the SEM Scanner technology as an adjunct to standard of care is highly likely to lead to significant financial benefits and cost savings⁴-¹⁴.

Clinical Evidence Summary on Pressure Injury Prevention

Download the PIP clinical evidence


1.Ore N, Carver T (2020) Implementing a new approach to pressure ulcer prevention.  Journal of Community Nursing, 34,4

2.Dealey C, Posnett J, Walker A (2012). The cost of pressure ulcers in the United Kingdom. Journal of Wound Care; 21(6):261-266.

3.Brem H, Maggi J, Nierman D et al. High cost of stage IV pressure ulcers. Am. J. surg. 2010; 200:473-477

4.Padula WV, Malaviya S, Hu E, Creehan S, Delmore B, Tierce JC (2020).  The cost effectiveness of sub-epidermal moisture scanning to assess pressure injury risk in U.S. Health Systems.  Journal of Patient Safety and Risk Management. 0(0):1-9. DOI:10.1177/2516043520914215

5.AHRQ. Never Events. 2017. Accessed August 2017

6.Centre for Medicare and Medicaid Services (CMS) (2013)

7.European Pressure Ulcer Advisory Panel, National Pressure Ulcer Advisory Panel & Pan Pacific Pressure Injury Alliance.  Prevention and Treament of pressure ulcers/injuries:Clinical Practice Guideline.  Emily Haesler (Ed.). EPUAP/NPIAP/PPIA:2019

8.Moore ZEH, Patton D.  Risk assessment tools for the prevention of pressure ulcers.  Cochrane Database of Systematic Reviews 2019, Issue 1.  Art No.:CD006471.DOI:10.1002/14651858.CD006471.Pub4

9.Samuriwo R. & Dowding D (2014)Nurses’ pressure ulcer related judgements and decisions in clinical practice: A systematic review.  Int J Nurs. 51(12):1667-85

10. Ross G, Gefen A (2019).  Assessment of sub-epidermal moisture by direct measurement of tissue biocapacitance. Medical Engineering and Physics. Vol 73:92-99

11. Smith G (2019) Improved clinical outcomes in pressure ulcer prevention using the SEM Scanner.  Journal of Wound Care. Vol 23(5)

12. Raizman R, MacNeil M, Rappl  (2018).  Utility of a sensor-based technology to assist in the prevention of  pressure ulcers: A clinical comparison.  Int Wound Journal.

13. Wood Z (2020). Real World Evidence Accepted and presented at EWMA Conference

14. Gefen A, Kolsi J, Grainger S, Burns M (2020) Modelling the cost benefits arising from technology-aided early detection of pressure ulcers.  Wounds International. Vol 11 (1): 22-29

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