A systematic review of therapeutic interventions for pressure ulcers after spinal cord injury

Arch Phys Med Rehabil. 2009 Feb;90(2):213-31. doi: 10.1016/j.apmr.2008.08.212.

Abstract

Objective: To systematically review evidence on the prevention and treatment of pressure ulcers in those with a spinal cord injury (SCI).

Data sources: For this evidence-based review, the following data sources were used: MEDLINE/PubMed, CINAHL, EMBASE, and PsycINFO.

Study selection: To be selected for inclusion in the current review, there had to have been an intervention, studies had to have 3 or more subjects, and 50% or more of the participating group had to have an SCI.

Data extraction: Data extracted included study design, subject demographics, inclusion and exclusion criteria, study type, sample size, outcome measures used, and study results.

Data synthesis: Articles selected for this review were organized into 1 of 2 categories: prevention or treatment. Within each broad category, several smaller ones were created, and articles were grouped according to the prevention (direct or indirect) or treatment intervention discussed.

Conclusions: Of the 26 articles selected for inclusion in the systematic review, 7 were randomized controlled trials (RCTs) that dealt with treatment for pressure ulcers, and there was 1 RCT on prevention. Despite the cost-effectiveness of prevention, little research exists on preventative interventions, and what does exist is mostly level 4 evidence. More research is needed for both prevention and treatment, but especially the former.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Clinical Trials as Topic
  • Electric Stimulation Therapy / methods
  • Equipment and Supplies
  • Health Behavior
  • Humans
  • Laser Therapy / methods
  • Paralysis / complications
  • Patient Education as Topic / organization & administration
  • Pressure Ulcer / etiology
  • Pressure Ulcer / prevention & control*
  • Pressure Ulcer / therapy*
  • Radiation
  • Spinal Cord Injuries / complications*
  • Telemedicine / organization & administration
  • Wound Healing

Grants and funding