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Integumentary Physical Therapy

What is Integumentary PT?

Definition

Physical therapy of the skin and the treatment of the diseases and conditions associated with the integumentary system.

Common Job

To help heal wounds, burns, skin ulcers, scars, and traumatic injuries, and promote tissue healing.

As a Professional

You must be able to examine and identify integumentary conditions, plan care for the patient, and make specialist/physician recommendations/referrals.

Thank You!

Patient Assessment

What is Integument?

Evaluation

Pain level

Strength

Mobility

Flexibility

Balance

Coordination

Wound Testing

Signs of infection

Activities and posture that are aggravating the wound

Characteristics such as bleeding, drainage, shape, and size

Scar tissue characteristics such as pliability, sensation, and texture

According to the National Library of Medicine...

Once Upon a Time...

Integument is "the primary interface between an organism and the environment"

Integument was once the predominant skeletal system. Much of our knowledge of early vertebrates is based off of fossilized elements of the skin.

Cell Damage

The Integument Provides...

Targets

"protection against mechanical insult and physiological stresses, and also plays obvious roles in communication, locomotion, and external stimulus detection and reception"

The two most common components of the cell that are targets of cell damage are the DNA and the cell membrane.

DNA Damage: Both normal metabolic activities and environmental factors such as ultraviolet light and other radiations can cause DNA damage, resulting in as many as one million individual molecular lesions per cell per day.

Cell Membrane Damage: Disturbs the state of cell electrolytes, e.g. calcium, which when constantly increased, induces apoptosis

Types of Reversible

Cell Damage

Distortion of microvilli

Loosening of intercellular attachments

Mitochondrial changes

Dilation of the endoplasmic reticulum

Wound Healing

Three Phases:

1. Inflammatory

2. Proliferative

3. Remodelnig

Who Needs Integumentary PT?

Intervention Strategies

Typical Client

Wound dressing

Manual therapy-massage for lymphatic drainage and pain reduction; range of motion stretching

Electrical stimulation (AKA "stim")

Fitting/ordering of adaptive, assistive, or protective equipment

Strengthening exercise

Patient education on current condition, risk factors, and plan of care

Someone suffering from wounds, burns, skin ulcers, traumatic injuries, scars, or abscesses.

Diagnoses Include:

Burns

Contusions

Neuropathic Ulcers

Pressure Ulcers

Vascular Disease

Surgical Wounds

Traumatic Injury

Abscesses

Bethany Presley

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