Jon[1]

Types of Patients in an Integumentary care setting
Abrasions
Pressure Ulcers
Neuropathic Ulcers
Venous Ulcers
Adhesions

Patients with Abrasion
Abrasion- a wound consisting of superficial damage to the skin.
Generally abrasions are common amongst patients who’ve fallen on a hard surface. Generally it’s a common injury amongst athletes. At a PT facility it is common to see patients with abrasions linking to sport related injuries such as patients with torn ligaments, tendons, muscles as well as fractures.

Treatment for skin abrasions and where treatment can be sought out
Treatment for abrasions generally include:
Cleaning the area of skin with mild soap and water.
Applying hydrogen peroxide
Use a semi permeable dressing to cover the wound.
Importantly for the patients benefit is to keep the wound moist until it has healed
Generally some forms of treatment may be applied towards the patient at a PT facility but mostly treating abrasions is done by the patient as more of a home remedy. Depending on the severity of the wound, the patient may seek the assistance of a physician in treating the wound.

Patients with Pressure Ulcers
Pressure ulcer is an area of injured skin and tissue.
Generally pressure ulcers develops on a patient sitting or lying in one position for too long. Generally pressure ulcers occur on patients:
Who cannot move on or change positions without someone else’s help, includes those who are in a coma, paralyzed, or have had a hip fracture.
Who have problems controlling their bowel or bladder functions.
Who have a lowered mental awareness caused by a medical condition, medicines or anesthesia.

Where and How to treat for Pressure Ulcers
Treatment for pressure ulcers typically involves debridement, wound cleansing, choosing the most appropriate wound dressing and, if indicated, selecting adjunctive medical therapies. Debriding and removing all necrotic tissue increase the likelihood for wound healing and decrease the chances of infection.
Adjunctive treatments include growth factors, electrical stimulation, hyperbaric oxygen, ultrasound, vacuum-assisted closure and bioengineered skin.
Treatment typically can be sought out at your own local physical therapy facility(outpatient setting, or in-patient hospital settings.)

Patients with Neuropathic Ulcers
Neuropathic ulcers is damages along the nerve fibers.
Mostly patients with diabetes develop this disorder. Generally patients with neuropathic ulcers lose the ability to feel pain and other sensations. Generally this disorder can be found along the bottom of a diabetics foot.

Where and How to Treat for Neuropathic Ulcers
Replacing shoes that are too tight will relieve pressure
Removing the callus regularly will also relieve pressure. This is done by a podiatrist.
It is better for healing if the wound is kept moist under a foam dressing which protects the ulcer from further trauma and yet allows oxygen to get through.
wearing an Orthowedge designed to reduce pressure at the front of the foot where most of the neuropathic ulcers are situated.
Treatment for Neuropathic Ulcers can be sought out by podiatrist, diabetes educator and an accredited practising dietitian.

Patients with Venous Ulcers
Venous ulcers is a shallow wound that develops when the veins do not allow blood back toward the heart normally.
This disorder mostly occurs with patients with severe obesity, women in pregnancy and patients with a blood disorder.

Venous Ulcers, Where and How to Treat
Wound care center
Treatment
The main thing of treatment for this ulcer is external compression to improve blood flow and decrease edema.
Compression stocking is the appropriate attire to use for good compression.
Compression stocking should be worn during daytime hours when the patient is upright. At night during sleep, the legs should be elevated so stocking don’t need to be worn.
Debridment is another way of treating venous ulcers. Debridement is the removal of dead, diseased or infected tissue from the wound bed to improve the potential for healthy tissue to heal
If you or someone you know think they have venous ulcers, the following below are a few wound care centers that can help assist in the care for this particular wounds.
http://www.northshorelij.com/body.cfm?ID=3917
http://www.svcmc.org/body.cfm?id=337
http://www.bchs.com/bayshore_wound_care_center.htm

Patients with developed adhesions
Adhesions is a dead fibrotic tissue that forms mostly in muscles, tendons, ligaments, fascia, and joints
Generally the types of patients seen with adhesions are patients with serious injuries around the joints. Also patients after surgery will develop adhesions like a patient recovering from post surgery of a torn achilles tendon.

Where and How to Treat Adhesions
Treatments for adhesions includes message therapy and certain modalities such as ultrasound
Using firm, deep strokes and moving in the direction of the muscle fiber is an affective way of breaking up scar tissue.
Ultra-sound is used to heat the injured area hot but the heat doesn't help to remove scar tissue. But the heat from the ultra-sound can make the scar tissue more pliable, massaging with deep cross fiber friction will do that.
Treatment for adhesions can be done by the person themselves and to some extent performed by a physical therapist. A professional physical therapist who specialize in advance massage techniques may be the best option.

Work Cited
"Treating Skin Abrasions." Sports Medicine, Sports Performance, Sports Injury - Information About Sports Injuries and Workouts for Athletes. Web. 21 July 2009. <http://sportsmedicine.about.com/b/2007/08/01/treating-skin-abrasions.htm>.
"Pressure Ulcers." Cleveland Clinic -- Home. Web. 21 July 2009. <http://my.clevelandclinic.org/disorders/pressure_ulcers/hic_pressure_ulcers.aspx>.
Scar Tissue Therapy. Silna, 2001. Web. 21 July 2009. <http://www.scartissuetherapy.com/>.
Sorensen, L. "Neuropathy." Royal Prince Alfred Hospital - Diabetes Centre. Web. 21 July 2009. <http://www.diabetes.usyd.edu.au/foot/Neurop1.html>.
"Wound Healing, Venous Ulcer." Columbia University Department of Surgery. Web. 21 July 2009. <http://www.columbiasurgery.org/cli/wound/venous_ulcer.html>.

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