Effects of hydrotherapy on pressure ulcer healing

Pressure ulcers are a prevalent and potentially serious medical problem encountered in both the medical and rehabilitation settings. Because the progress of rehabilitation is often interrupted by the presence of pressure ulcers, the efficient care of these wounds is of great interest to the rehabilitation team. Patients in two acute care facilities with Stage III or IV pressure ulcers were identified and consented to participate in the study contained herein. All wounds were mechanically debrided of necrotic tissue, and then the patients were randomly assigned to the conservative treatment group (A; n = 18) or the conservative treatment plus whirlpool group (B; n = 24). Conservative treatment included measures to maximize pressure relief and wound care with wet-to-wet dressings using normal saline. The dressings were changed twice daily and when they became soiled. Whirlpool was administered for 20 min per day in Group B patients. Only those patients whose ulcers were followed-up for 2 or more wk were included in the study. Ulcers were then measured by a physician who was blinded as to the treatment groups. Ulcer dimension changes over time were compared between groups. The results indicate that the conservative treatment plus whirlpool group improved at a significantly faster rate than did the conservative treatment only group (P < 0.05).