Integument: Guidelines for the care of people with spina bifida.
Patricia Beierwaltes, Sharon Munoz, Jennifer Wilhelmy
PMID 33252092WHAT IT FOUND
Experts recommend daily skin checks for people with spina bifida, focusing on weight-bearing areas and insensate skin.
Care plans vary by age, shifting from caregiver-led inspections in infants to self-management and pressure-relief routines in older children and adults.
Key findings
01Guidelines emphasize preventing skin breakdown through daily inspections of weight-bearing or insensate areas for changes in color, texture, and temperature.
02Recommendations include using barrier creams for incontinence, checking water temperature with a thermometer, and avoiding hot surfaces like sun-exposed car seats.
03For wheelchair users, guidelines advise using pressure-relieving cushions checked daily and engaging in pressure-relieving activities every 15 minutes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The guidelines rely heavily on expert consensus and evidence from other populations because spina bifida-specific evidence is limited. The document focuses on prevention and does not provide guidelines for the treatment of existing pressure injuries. The recommendations are broad and require individualization based on the patient's functional abilities and specific risk factors.
Declared interests
The text notes that the methodology was published by Dicianno et al. and involved experts from the National Spina Bifida Patient Registry, but does not list specific financial conflicts of interest or funding sources for this particular guideline document.
The easy way to misread this
Do not treat these recommendations as evidence that specific interventions reduce pressure injury rates in people with spina bifida. The guidelines are based on expert consensus and extrapolated evidence, not on trials testing these specific strategies in this population.