Early Detection of Pressure Injury Using a Forensic Alternate Light Source

Heather Hettrick, PT, PhD, CWS, CLT-LANA, CLWT; Cheryl Hill, PT, PhD, DPT; Patrick Hardigan, PhD


Wounds. 2017;29(8):222-228. 

In This Article


The study and protocol had several limitations. Every attempt was made to voluntarily enroll as many participants as possible with the goal of including 30 participants. Although 10 enrolled, only 7 participants completed the study. Despite participants residing in long term care, many were not interested in participating and others had cognitive limitations negating consent.

With respect to the ALS equipment used in the study, it is rather large and cumbersome given its primary usage at crime scenes. It requires robust fans to keep the equipment cool due to the power needed to provide the necessary luminosity for the respective wavelengths. A follow-up study is being designed to explore the use of a handheld ALS device to determine if the luminosity provided by the handheld device is powerful enough to detect tissue trauma changes as shown with the equipment used herein. A handheld ALS device may provide a simple, user-friendly, and clinically relevant screening tool for early detection of pressure injury.

The study protocol inherently had several limitations. To maximize visualization with the ALS, data were collected in the evening to reduce the potential for natural light to interfere with the ALS. This was also more convenient for the participants. Black sheets were employed to isolate the participants' heels for photography. The protocol and equipment used in this study required 5 people to collect data: 1 person to manage the ALS equipment, 1 to take the photographs, 1 to record the data, and 2 to manage the sheets and maintain participant positioning. Further, the ALS equipment used for this study is costly and may not be financially feasible in its current format for clinical use. This further justifies the need for an additional study to explore the use of less expensive, handheld ALS devices.