Pressure ulcers in SCI: does tension stimulate wound healing?

Some Problems of the Lower Extremity in Patients with Spinal Cord Injuries

Spinal cord injury (SCI) is devastating, leaving patients wholly or partly paralyzed. Health care providers who care for SCI patients during the acute or chronic phases are faced with different phenomena in the lower extremities of these subjects. In this article, the authors review the relevant changes associated with SCI. Preventive measures of these medical complications are directed according to the specific cause. Early comprehensive rehabilitation carried out by a specialized team prevents complications while enhancing functional gains.

Can the use of an early mobility program reduce the incidence of pressure ulcers in a surgical critical care unit?

The Agency for Healthcare Research and Quality has defined pressure ulcers (PUs) an important patient safety indicator (#3). Despite the existence of evidence-based guidelines for PU prevention and treatment from the United States Department of Health and Human Services, the sustained success in reducing the development of PUs is elusive in many acute care hospitals.

PURPOSE

The specific aim of the study was to determine whether the implementation of an early standardized process for mobility could reduce or eliminate the development of PUs in a surgical intensive care unit.

METHODS

Patient data were collected pre- and postimplementation of the early mobility protocol.

RESULTS

The mobility compliance for patients postimplementation was 71.30% (SD = 12.73), with a range of 25% to 100%. A χ² test for independence (with Yates continuity correction) indicated a significant association between unit-acquired PUs and the pre- and postimplementation mobility groups (χ²(1,1051) = 6.86, P = .009). Specifically, patients in the intervention group had significantly more unit-acquired PUs than the control group. No significant differences were identified between the 2 groups.

IMPLICATIONS/CONCLUSIONS

Despite implementation of the early mobility protocol, we did not see an improvement in the PU rate overall or with time as protocol compliance improved.