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PT Classroom - Wound Care Basics for the Physical Therapist ׀ by Ryan Garman, MPT |
Ryan Garman graduated from Marquette University with his Master of Physical Therapy degree. His training in physical therapy includes orthopedics, inpatient rehab, and wound care. Ryan is a certified clinical instructor through the APTA and enjoys mentoring physical therapy students. He is currently a physical therapist practicing at United Hospital System. |
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Introduction
Wound care is a specialty area of physical therapy that involves prevention, assessment, and treatment of acute or chronic wounds. Physical therapists often come across patient populations that may be more susceptible to the development of wounds. Therefore, they have the opportunity to help these patients minimize or prevent such occurrences. They accomplish this by helping patients understand how pre-morbid conditions such as diabetes or vascular insufficiency can influence the body’s response to external stimuli. They also educate and teach patients who have diabetes or poor venous return how to regularly perform foot inspections, avoid prolonged positions and increase their activity levels so they minimize their likelihood of developing a wound. Types of Wounds Vascular wounds which are due to venous insufficiency are characteristically associated with edema, a large amount of drainage, hemosidering staining (brown discoloration), and pain when the foot is in a dependent position. Treatment generally includes compression bandages such as Unna boot or Profore wrapping. Arterial insufficiency wounds occur
more often distally, have pain from intermittent claudication, and
can become necrotic or gangrenous. Revascularization needs to take
place for these wounds to heal.
Last revised: April 10, 2008 |
The
skin is the body’s largest organ and is responsible for protection,
temperature regulation, and sensation. As skin ages, it becomes
dehydrated, has decreased blood flow and loses its elasticity. The
various
layers of the skin which includes the epidermis, dermis, and subcutaneous tissue
becomes more susceptible to an
injury as a result of these changes. An everyday accident such as bumping your arm on the refrigerator
could even result in damage to the skin!
The treatment of wounds can change with the introduction of every new type
of dressing or chemical. While it is sometimes indicated, the use of betadine whirlpools in wound care is no longer the popular
alternative to treating infection or hydrating eschar. Based on the
type, location and assessed characteristics of any individual wound,
the therapist and doctor must decide on an appropriate treatment
plan. The key goals in determining how to treat a wound are to
reduce risk factors, eliminate non-viable tissue, increase mobility
of soft tissues, protect viable tissue as it develops, and to
educate patients and caregivers in order to prevent further recurrence.|
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