Essential Interventions Physical Therapists Provide in Wound Management Care Plan
Updated: Mar 30, 2021
Many people don’t realize that PTs can play a vital role in developing a proper wound management care plan as they possess in-depth knowledge of anatomy and tissue healing as well as mobility and positioning expertise. PTs perform an initial, comprehensive functional assessment on all patients to assess their range of motion, strength, mobility, ability to transfer, usage of assistive devices (wheelchairs, walkers, canes, etc.) and gait issues. In their role, PTs use this overall assessment to determine appropriate evidence-based interventions to address the identified functional deficits and develop a wound management care plan.
PTs play an essential role in developing proper wound management care plans and provide interventions in both the prevention and the healing of wounds. Some of these interventions are as follows:
Positioning - PTs assist patients, their caregivers, and their family members in positioning the patient to alleviate pressure on existing wounds or prevent the development of new pressure ulcers(injuries). This includes the selection of the proper support surfaces - specialized beds, mattresses, and wheelchair cushions as the surface on which a person lies or sits may contribute to the formation of pressure ulcers.
Edema Management - PTs perform ankle-brachial indexes (ABIs) then safely choose and apply compression bandaging systems in conjunction with massage techniques that can assist in reducing edema associated with poor venous insufficiency and lymphedema.
Orthotics Usage - PTs perform assessments on the feet of diabetic patients for deformities and pressure points. An analysis of the patient’s gait informs the use of offloading footwear to promote the healing of existing diabetic foot ulcers and prevent the formation of new ulcers.
Sharps Debridement - PTs use sharp tools to debride non-viable tissue and promote healing.
In addition, PTs are trained in providing certain advanced wound management care plans and that include:
Pulse Lavage - provides irrigation to promote circulation and decrease healing times.
Ultrasound Mist Therapy - delivers ultrasound waves through a saline mist to increase blood flow to the wound, disrupt the biofilm, and accelerate wound healing.
Electrical Stimulation (E-stim) Therapy - enhances wound healing through the use of electrical currents which stimulates cell growth and improves blood flow.
Negative Pressure Wound Therapy (NPWT) - increases blood flow to the wound site leading to decreased healing times.
Compression Therapy - Compression therapy counteracts the force of gravity and promotes the normal flow of venous blood up the leg and reduce edema.
Total Contact Casting - The best practice intervention for neuropathic diabetes foot ulcers is typically performed by physical therapists. The cast assists in off-loading the weight on the foot ulcer, which in turn facilitates healing.
To learn more about the physical therapist’s important role in developing a wound management care plan, please download our white paper - “The Role of the Physical Therapist in Wound Healing” by Harriett Loehne, PT, DPT, CWS, FACCWS.
Dr. Loehne, a member of Corstrata’s Clinical Advisory Board, is a leading expert and consultant in physical therapy and the vital role the profession plays in wound management and currently serves as the president of the American Physical Therapy Association’s Academy of Clinical Electrophysiology and Wound Management (ACEWM) and Chairperson of the Task Force for an American Board of Physical Therapy Specialties (ABPTS) physical therapy Wound Management Clinical Specialty.