Guihan M, Hastings J, Garber SL, et al.
The journal of spinal cord medicine. Date of publication 2009 Jan 1;volume 32(5):560-7.
1. J Spinal Cord Med. 2009;32(5):560-7.
Therapists' roles in pressure ulcer management in persons with spinal cord
injury.
Guihan M(1), Hastings J, Garber SL.
Author information:
(1)Center for Management of Complex Chronic Care (CMC3) Edwards Hines, Jr. VA
Hospital (151-H), 5000 S. 5th Avenue, Hines, IL 60141-3030, USA.
Marylou.guihan@va.gov
BACKGROUND: Among veterans with spinal cord injury (SCI), severe pressure ulcers
(PrU) are treated by interdisciplinary rehabilitation teams in SCI units.
METHOD: Cross-sectional survey administered to therapists attending a conference
of the Therapy Leadership Council in SCI.
PARTICIPANTS: Respondents included physical therapists (PTs; n=24) and
occupational therapists (OTs; n=15).
MAIN OUTCOME MEASUREMENTS: Wound care practices as indicated by 75% or more of
participants as "usual practice".
RESULTS: In general, therapist involvement with wound care was initiated by
physician order (e.g., electrical stimulation) or postsurgery protocols. "Usual
practice" after tissue healing included progressive range of motion; initial
remobilization (first sitting after wound healing); progression of sitting time
including assessment of skin tolerance; instruction in pressure relief
maneuvers/techniques; and instruction in safe transfers. Practices in prevention
of a new ulcer included education and evaluation of seating posture/positioning.
CONCLUSIONS: Results indicate that centers may delegate responsibilities for
management of ulcers differentially by discipline. A limitation was that we were
unable to determine whether these centers were the same or different for OT and
PT respondents. Although sample size was small and some sites had multiple
respondents, the survey showed a growing role for OTs and PTs in PrU treatment.
Because 75% of each discipline reported that there were usual practices,
including patient education and remobilization protocols, this area requires
further study to determine the clinical outcomes in terms of preventing PrUs and
recurrence.
PMCID: PMC2792462
PMID: 20025152 [Indexed for MEDLINE]
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