Team Approach to Treatment of Spinal Cord Patients with Complex Wounds

Chronic pressure ulcers are a significant National health problem. Patients at greatest risk include the elderly, those with debilitating diseases such as spinal cord injuries, MS and others that are rendered immobile. Evolution of these wounds can lead to infection, sepsis, and osteomyelitis. Treatment is a challenge and a collaborative approach is essential, requiring the efforts of a multidisciplinary team in numerous settings across the continuum.  This poster will demonstrate the efforts of such a team to provide aggressive care to spinal cord patients with complex wounds.  Members of the team include surgeons,internists, infectious disease specialists, nurse practitioners(NP), nutritionists, social services and of course at the center, the patient and their support network.

The program was designed to provide continuity of care to spinal cord patients. Treatment begins from the initial contact with the team.  An individualized plan of care is developed with an end point defined. Frequently the patient will need wound debridement, treatment of osteomyelitis, nutrition resuscitation and subsequent flap reconstruction.

The program is directed by the reconstructive surgeon who integrates the recommendations from the other consultants. The NP who follows the patient closely becomes one of the key providers and advocates for these patients and is essential in providing communication along the continuum from acute care to long term care to rehab, not only to the patient but to other members of the team.  

Case studies will be shared in this poster to demonstrate how a multidisciplinary team approach to provide appropriate continuity of care, aggressive wound care, nutrition support, planned surgical reconstruction with a coordinated perioperative care plan can promote excellent outcomes in spinal cord patients with complex wounds.