Measures of Skin Turgor in Humans: A Systematic Review of the Literature

Abstract

BACKGROUND: Many studies use similar methods to measure skin turgor, but there is no gold standard method that is being followed in clinics or hospitals. PURPOSE: The purpose of this systematic review was to determine if there is any consistent method to measure skin turgor in humans that is valid and reliable. METHODS: Topics of interest for turgor assessment included dehydration; skin integrity, including wounds and skin flaps; and fluid/electrolyte balance for adults 18 years and older. PubMed, ProQuest Medical, SPORTDiscus, PEDro, Web of Science Core Collection, and Cumulative Index of Nursing and Allied Health Literature complete databases were utilized. Levels of evidence were established with 2011 Oxford Centre for Evidence-Based Medicine scale. Methodological rigor was assessed with Quality Assessment of Diagnostic Accuracy Studies checklist. Two researchers graded rigor and level of evidence with a third researcher serving as a tie-breaker. RESULTS: Thirteen articles were included in the final analysis. Some researchers used skin turgor as a measure but did not give details regarding specifically how this measure was used. The pinch test was the most commonly used measure of skin turgor. There were 4 articles ranked as evidence level 2, 1 article as evidence level 3, and 8 articles as evidence level 4. Rigor scores ranged from 3 to 13/14. CONCLUSION: Skin turgor may not be the best assessment tool for some conditions or purposes in adults, such as dehydration, which could lead to a medical emergency.