Tag: Wound Care
Wheelchair cushions designed to adjust to a person’s size and form can help redistribute pressure and provide support for activities of daily living for patients with spinal cord injuries, report scientists at the Instituto Nacional de Rehabilitación (Rehabilitation National Institute) in Mexico City. The cushions seem to provide the most benefit to patients with high thoracic and incomplete cervical injuries.
The study’s 14 participants received a cushion obtained from a mold taken of their hips and buttocks, designed to prevent pressure ulcer formation while maintaining or promoting functionality.
Over the last couple of days, the Reeve Foundation has focused on supporting relief efforts that are directed at the people of Haiti with existing and newly acquired disabilities. Portlight Strategies and UCP Wheels For Humanity are a perfect match for our mission and are mobilizing rapidly.
Both of these organizations are known to the Reeve Foundation from previous Quality of Life Grants and are already in motion shipping medical supplies and wheelchairs to Haiti.
What do you know about bedsores? They come from too much pressure on your skin in one place for too long. If you are paralyzed, and have no sensation, say, on your butt, you might not even be aware you have one. And it can kill you.
Believe it or not, an ongoing controversy concerning whether or not bedsores are preventable was resolved when Medicare declared pressure ulcers (bedsores) a “never event”, i.e. a medical error.
The most severely wounded and disabled US soldier to return home from Iraq is a Filipino-American by the name of Joseph “Jay” Briseno Jr. Shot in 2003 in the back of the neck at pointblank range that severed his spinal cord and left him quadriplegic and blind, Jay now lives with his parents and siblings in Virginia and requires full-time, around-the-clock care.
In an article by news editor Edmund Silvestre published in the Filipino Reporter, Jay’s father Joseph Sr., a retired US Army sergeant, describes the extent of his son’s injuries and needs: “Aside from spinal cord and brain injuries, Jay also suffered two cardiac arrests and has been attached to a life support… doctors told us that he would die, that it’s impossible for him to survive his injuries and that it’s best for all of us if he were to die.”
Paralyzed from his chin down, Jay cannot eat, move, speak or breathe on his own, Silvestre writes. “Although conscious, his ability to communicate is severely limited.”
Take Routine Care of Your Skin
The third way to prevent skin sores, the most serious problem in SCI, is to keep your skin healthy. Health skin is skin which is intact, well lubricated with natural oils, and nourished by a good blood supply. Skin stays healthy with good diet, good hygiene, regular skin inspection, and regular pressure relief. We’ve already discussed skin inspection and pressure relief. We’ll focus here on hygiene and nutrition.
Hygiene -You must keep your skin clean and dry. Skin which is frequently moist from urine, sweat, or stool is more likely to break down. Dry skin well after bathing, but don’t rub hard with a towel as rubbing can damage the skin. You may have heard that alcohol massages over bony areas are good for you. They are not. Alcohol dries out your skin and dried, cracked skin is not healthy. If back rubs help you to relax, a gentle one with lotion should be given.
How Does NPWT Work?
Two NPWT devices are primarily used in the United States: the V.A.C.[R] (Vacuum Assisted Closure) Therapy[TM] system, offered by Kinetic Concepts, Inc. (KCI), and the Versatile 1[R] Wound Vacuum System by BlueSky Medical Group. Both use a closed system, meaning that neither the wound nor the components of the treatment are exposed to the air.
The V.A.C. system is applied to an open wound for periods of 48 hours. Suction is directed at the surface of the wound through an interface between the wound surface and either a black polyurethane or white polyvinyl alcohol foam that is cut to the appropriate shape of the wound and is then inserted to contact the entire wound.
V.A.C.® Therapy is the controlled application of sub-atmospheric pressure to a wound using a therapy unit to intermittently or continuously convey negative pressure to a specialized wound dressing to help promote wound healing. The wound dressing is a resilient, open-cell foam surface dressing (such as GranuFoam® and Vers-Foam™) that assists tissue granulation and is sealed with an adhesive drape that contains the subatmospheric pressure at the wound site. Special T.R.A.C.® technology* enhances patient safety by regulating pressure at the wound site. Additionally, the V.A.C.® Therapy System helps direct drainage to a specially designed canister that reduces the risk of exposure to exudate fluids and infectious materials.
·turning & repositioning
- When in bed, turn or shift at least every two hours. Use the free Turning Clocks from WCD to customize your own turning schedule.
- When sitting, shift weight at least every 15 minutes.
- Moisturize the skin with body lotion or cream, but avoid massaging bony prominences.
The American Medical Directors Association crafts guidelines specifically for long-term care
Pressure ulcers are serious problems not only for nursing home residents, but for the long-term care industry, as well. In today’s litigious climate, nursing homes must take steps to ensure that their wound management programs quickly identify, treat and, preferably, prevent pressure ulcers. To help them devise programs that are best for both residents and the industry, the American Medical Directors Association (AMDA) offers the Pressure Ulcer Therapy Companion.
Abdominal Binder – Wide elastic binder use to help prevent a drop in blood pressure or used for cosmetic purposes to hold in abdomen. A rigid (non-elastic) binder is used to help empty the bladder in some patients.
Aces – Elastic bandage used to wrap extremities to help support and prevent blood pressure from lowering.
Acute rehabilitation program – Primary emphasis on the early Rehabilitation phase which usually begins as soon as a person is medically stable. The program is designed to be comprehensive and based in a medical facility with a typical length of stay of 2-3 months. Treatment is provided by and identifiable team in a designated unit.