Thuisbehandeling van decubitus bij dwarslaesiepatiënten

Background: Patients with spinal cord injury (SCI) are vulnerable for pressure ulcers and experience serious problems in case of a pressure ulcer. De Hoogstraat Rehabilitation offers home treatment for patients with SCI and pressure ulcers since 2007. Aim: To describe the results of home treatment of SCI patients with a pressure ulcer on the sacrum, tuber and to provide recommendations to improve the quality of the outpatient care for this group. Methods: A sample of 40 patients, stratified for age and sex, was selected out of a total of 393 patients visiting the outpatient clinic for pressure ulcers between 2007 and 2011. Demographic data, SCI data and wound healing data was collected from their medical files. Out of these 40 patients a sample of 10 patients, stratified for age, sex, duration of healing and grade of pressure ulcer was selected for a semi-structured interview on their experiences of having home treatment for a pressure ulcer. Findings: In 23 out of 40 patients the pressure ulcer healed at home. In 13 of these 23 patients the ulcer healed within 3 months. Of the 17 patients who needed hospitalization, 7 healed with conservative treatment and 10 needed an operation. Patients experienced a range of somatic, functional, psychological and social problems during the healing of their pressure ulcer. Conclusion: Home treatment was successful in over half of the treated SCI patients with a pressure ulcer. It is recommended to develop criteria for the selection between clinical treatment and treatment at home to improve effectiveness and efficiency of pressure ulcer care