ArticleFrontiers in physiology2026
Skin thickness alterations in pressure injury tissue: insights from high-frequency ultrasound and mixed-design analysis of variance.
Article in Frontiers in physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose/aim: To quantify skin thickness alterations in pressure injury (PI) tissue and evaluate the influence of PI risk factors using high-frequency ultrasound. Background: Early PI detection remains challenging due to limitations of visual assessment. High-frequency ultrasound (HFUS) offers high-resolution skin imaging but lacks validation in PI tissues. Design: Prospective comparative study. Methods: In this cross-sectional study, we assessed skin thickness in 42 bedridden patients with pressure injuries (PIs). For each patient, measurements were taken at the PI site and an adjacent normal site using high-frequency ultrasound (18 MHz). A mixed-design ANOVA tested the effects of tissue type (within-subject: PI vs. normal), PI risk status (between-subject: high vs. low), and body mass index (BMI: ≥24 vs.<24 kg/m²), including all main and two-way interaction effects. Results: Skin at pressure injury (PI) sites was substantially thicker than at adjacent normal sites (3.26 ± 0.63 mm vs. 2.11 ± 0.52 mm). A mixed-design ANOVA confirmed a large, significant main effect for tissue type (F (1, 38) = 57.980, p< 0.001, Conclusions: HFUS-detected skin thickening is a hallmark of PI tissue, primarily driven by local pathology and modulated by systemic risk factors. HFUS shows potential for objective PI assessment.
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