Miscellaneous Physical Treatments

Although pressure redistribution to reduce ischemia is the primary method for pressure injury 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.

Discussion

Tzen et al. (2013) were able to confirm that microclimate control was an effective pressure injury 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.

Conclusion

There is level 2 evidence (from one prospective controlled trial: Tzen et al. 2013) that localized cooling is not a viable pressure injury 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 injury prevention strategy.