Contribution of therapeutic education to the prevention of pressure ulcers in spinal cord injury

Objective Spinal cord injuries (SCI) are not chronic illness, but a new state of life that requires several adaptations. It seems particularly interesting to apply the concept of therapeutic patient education (TPE) on SCI to prevent the occurrence of pressure ulcers (PU). The aim of our study was to evaluate the contribution of TPE in SCI to prevent the occurence of PU. Material/patients and methods It was a prospective study. Two groups of SCI were randomized to 25 subjects. The first group (G1) had the usual advices and the second group (G2) had a TPE according to a guide that we established. All patients had an initial assessment of their knowledge and a second one three months later. Results Fifty patients were included. There was no statistically significant difference between two groups concerning age, sex and ASIA score. There were no patients with urinary incontinence in either group. The initial assessment revealed moderately knowledge in both groups regarding mechanisms of onset of PU, its complications, its risk factors, monitoring of the skin condition, areas of risk to be monitored, relief of fulcrums, signs of PU and the role of good body hygiene. The knowledge was considered bad for the items risk of the tobacco on cutaneous healing, situations conducing to the appearance of pressure scores, warning signs prior to the occurrence of PU, quality control of the support surfaces in the prevention of PU, the role of balanced nutrition, the choice of clothes and adapted sheets and how to deal with redness of the skin. At the three-month evaluation, we found a statistically significant improvement in G2 responses. Thirteen patients in G1 developed PU. Only 3 patients in G2 developed PU. Discussion – conclusion Our study showed the efficacy of TPE of SCI in order to improve their knowledge and consequently their practices for the prevention of PU. Therefore the patient must participate at his own care.