Treatment of pressure ulcers by serial casting in patients with severe spasticity of cerebral origin.
OBJECTIVE
To assess the effectiveness of serial casting in the treatment of pressure ulcers caused by severe spasticity.


METHODS
Case series.


METHODS
A clinic for the rehabilitation of persons with neurologic disorders.


METHODS
Nine patients with 11 pressure ulcers resulting from severe cerebral spasticity, the ulcers being intractable to conventional management because of repeated friction and/or inaccessibility.


METHODS
Serial casting of the limb(s) with the pressure ulcer(s), with either fenestration or a cast arch providing access to the wound.


METHODS
Improved healing of pressure ulcers, as quantified with the National Pressure Ulcer Advisory Panel classification system.


RESULTS
Within a mean of 4.6 weeks, 7 ulcers healed completely and 4 improved markedly. The casting caused no complications. Moreover, extension deficits improved markedly in all patients (105 degrees +/- 27 degrees to 17 degrees +/- 10 degrees ).


CONCLUSIONS
Serial casting may be a valuable tool in the treatment of pressure ulcers at the extremities of patients with severe cerebral spasticity.
Pohl
Marcus
M
Department of Neurological Rehabilitation, Bavaria-Klinik, Kreischa, Germany. pohl@klinik-bavaria.de
Rückriem
Stefan
S
Strik
Herwig
H
Hörtinger
Bettina
B
Meissner
Daniel
D
Mehrholz
Jan
J
Pause
Max
M
D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D002370:Casts, Surgical; D003286:Contracture / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000150:complications*; D003668:Pressure Ulcer / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome