Pressure injuries cost VA facilities up to $3.6 billion a year. In one study the guideline reviewed, patients assessed with SEM had 93% fewer pressure injuries.
LOS ANGELES, September 24, 2026 — The Department of Veterans Affairs (VA) and the Department of Defense (DOD) have published their clinical practice guideline for pressure injuries, and it recommends sub-epidermal moisture (SEM) measurement.¹ The guideline states: “We suggest the use of sub-epidermal moisture measurement to identify patients at risk for pressure injuries and/or early diagnosis of pressure injuries.”
Pressure injuries often start from the inside out, deep in the tissue over a bone, long before signs of damage are visible on the skin. By the time the skin opens, the guideline notes, the damage may have been developing for five to seven days. SEM measurement detects the fluid that builds up in damaged tissue. In the studies reviewed, it flagged pressure injuries an average of four days before they could be seen. Four days is time for nurses to reposition the patient, manage moisture and reduce shear on the spot the scanner flags, while the skin is still intact.
“Veterans and service members have already sacrificed a great deal for our country. A pressure injury should not be added to it,” said Martin Burns, Chief Executive Officer, Bruin Biometrics. “This guideline gives VA and DOD nurses a reading that finds the damage days before it breaks the skin. That is when it can still be stopped.”
What pressure injuries cost the VA
- Up to $3.6 billion a year. Congress reported in 2020 that treating hospitalized patients with pressure injuries costs VA facilities $1.3 billion to $3.6 billion a year.
- $1 million every 20 minutes. The VA reported hospital-acquired pressure injuries cost U.S. health care $26 billion a year.
- Up to $100,000 per wound. A single stage 3, stage 4 or unstageable injury costs $75,000 to $100,000 to treat, and pressure injuries lengthen hospital stays by 57%.
- Veterans with spinal cord injuries. One in three develops a pressure injury within a year of injury. Each costs about $70,000 more and stays nearly 52 days longer in hospital.
What the evidence showed
- More injuries found, sooner. SEM sensitivity was above 80% in three studies, against 50% for visual skin assessment. SEM found injuries four days earlier on average in two studies, and 8.2 days earlier in a third.
- Fewer injuries. One non-randomized study found 93% fewer pressure injuries with SEM than with visual assessment alone.
- Across skin tones. Studies consistently found SEM eliminated bias in detecting early tissue damage across skin tones. The work group called for more research in darker skin tones.
The work group found the benefits outweigh the harms, and that the cost of an SEM scanner “must be weighed against the potentially enormous savings in pressure injury care and management.”
The VA/DOD Clinical Practice Guideline for the Prevention and Management of Pressure Injuries is available at healthquality.va.gov.
About Bruin Biometrics
Bruin Biometrics is a medical device company transforming pressure injury prevention through objective, physiologically based assessment. The Provizio® SEM Scanner uses biocapacitance to identify and measure changes in localized tissue fluid associated with pressure-induced damage before those changes become visible at the skin’s surface, helping clinicians detect early tissue damage, direct anatomically targeted care, monitor tissue response and pursue the defining endpoint of prevention: keeping skin intact. For more information, visit www.bruinbiometrics.com.
Media Contact: Ryan Kraudel • VP Marketing • rkraudel (at) bruinbiometrics (dot) com • +1-301-268-9494
Important information: SEM measurements are not independently diagnostic of a pressure injury. Results should be evaluated in the context of the patient’s overall condition, established clinical protocols, clinical judgment and the product’s applicable indications for use. References to the VA/DOD Clinical Practice Guideline do not imply endorsement by the Department of Veterans Affairs or the Department of Defense.
¹ U.S. Department of Veterans Affairs and Department of Defense. VA/DOD Clinical Practice Guideline for the Prevention and Management of Pressure Injuries, Version 1.0. 2026.
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