Miscellaneous Physical Treatments

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Although pressure redistribution to reduce ischemia is the primary method for pressure ulcer prevention and management, it is also understood that decreased skin temperature leads to reduced tissue metabolic demand that might translate to reduced reactive hyperemia post ischemia. To test this theory, Tzen et al. (2013) compared the effects of controlled local cooling on reactive hyperemia resulting from pressure induced ischemia for people with and without SCI.

Table: Localized Cooling for Treatment of Pressure Ulcers


Tzen et al. (2013) were able to confirm that microclimate control was an effective pressure ulcer prevention strategy in at-risk individuals without SCI; unfortunately, this was not the case for individuals with neurologically compromised vasoconstriction and capillary smooth muscle contraction as in people with SCI.


There is level 2 evidence (from one prospective controlled trial; Tzen et al. 2013) that localized cooling is not a viable pressure ulcer prevention strategy that is effective for individuals with SCI. Conversely, with neurological control of vasoconstriction and capillary smooth muscle contraction, those without SCI may benefit from microclimate controlled surfaces as a pressure ulcer prevention strategy.

  • Pressure point localized cooling is not an effective pressure ulcer prevention strategy for people with SCI.