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Factors that Contribute to Skin Breakdown

Kirsten Davin, OTD, OTR/L, ATP, SMS

July 28, 2014

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Question

What factors contribute to skin breakdown in clients with limited mobility?

Answer

There are three components to skin breakdown, heat, moisture and pressure.  Heat can be either internally generated, such as from body heat, or externally generated, such as environmental temperatures.  Moisture can result from oils and sweat from the skin or from incontinence.  Finally, pressure is caused by the force of the client’s body mass onto the seating surface.

Our treatment plan needs to focus on minimizing the effects of externally generated heat, eliminating moisture due to incontinence and minimizing pressure with proper positioning and seating systems.

 

Editor’s note: This Ask the Expert was adapted from the article ‘Pressure Mapping: A Valuable Resource for Client Assessment & Education’.  The complete article can be accessed here


kirsten davin

Kirsten Davin, OTD, OTR/L, ATP, SMS

Dr. Kirsten Davin is a veteran Occupational Therapist of nearly 20 years, with extensive experience in a variety of practice settings including inpatient rehabilitation, acute care, intensive care, and the Central Illinois Regional Burn Center. Since initially obtaining her bachelor’s in occupational therapy in 2001, followed by her post-professional OT Doctorate (OTD) in 2007, Kirsten has served not only as a clinician but also in the role of a clinical consultant specializing in product design and development. Kirsten has fabricated hundreds of splints within her acute care and clinical consulting career, many of which were custom fabricated and individually designed on a case-by-case basis. Her splinting experience ranges from a standard safe position and resting hand splints to highly intricate dynamic splints for the hand, wrist, lower extremities, and cervical spine, incorporating all varieties of materials and splinting medium.

For more than a decade, she has been best known for her live, national speaking tours, which to date have reached over 20,000 therapists in 46 states.  She has conducted thousands of educational events on the topics of seating/positioning, assistive technology, work-life balance, acute care/ICU rehabilitation, splint fabrication, orthotic application, and more. Dr. Davin is an engaging speaker who strives to make learning fun. 

 


Related Courses

Navigating The Journey: OT’s Role In Oncology And Navigating End-of-Life Care
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In this course, types of pre-cut, pre-formed and sheet-based splint fabrication techniques are explored as well as a comparison between volar and dorsal-based approaches. A detailed demonstration of four types of forearm-based wrist orthotics are presented, including radial gutter/thumb spica splints, dorsal and volar wrist cock-ups, and functional position with an intrinsic plus modification option. This course is Part 2 of a 4-part series on static splinting.

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Types of pre-cut, pre-formed and sheet-based splint fabrication techniques are explored as well as video demonstration of the fabrication of a hand-based thumb spica, finger gutter and MP joint blocking splints. In addition, the application and use of a spring finger extension splint, oval 8 splints as well as static progressive finger flexion and extension splints are discussed.

Successful Static Splinting: Fabrication for Specific Diagnoses, Part 4
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Types of pre-cut, pre-formed and sheet-based splint fabrication techniques are explored as well as instruction on the fabrication of a foot plate for external fixator application, the application of lower extremity splints and orthotics as well as splinting considerations for specific diagnoses including burn injury. A focus on creative splinting techniques is emphasized.

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