Physical therapy encompasses a broad area of treatments and interventions, including wound management for patients. Some of the wound care procedures assist with cleaning of the wound bed, promote healing, management of resulting scar and debridement. Debridement is the manual removal of nonviable tissue using instruments. Therapists can also use hydrotherapy procedures to debride and prepare the wound for manual debridement.
Two types of hydrotherapy procedures can be done to assist with debridement and cleansing of a patient’s wound: whirlpool and pulsatile lavage.
Whirlpool effects can cause softening of necrotic tissue and improve healing by increasing circulation, which brings nutrients to the area.
Pulsatile lavage cleanses with debridement with use of a water pick suction device. It also causes a negative pressure to remove necrotic tissue to reduce infection and enhance healing.
All treatments of hydrotherapy and manual debridement require a physician’s order. A thorough physical therapy evaluation must be completed prior to treatment since there are contraindications and precautions to treatment of wounds. Patients vary from slow healing wounds, diabetic ulcers, status post-surgery with an open wound, peripheral vascular disease with an open wound, burns, skin grafts, wounds caused by motor vehicle accidents and more.
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