Comparative Study of Risk Factors for Skin Breakdow With Cervical Orthotic Devices

Black, Cheryl; Buderer, Nancy; Blaylock, Barbara; Hogan, Barbara J.

doi:10.1097/00043860-199807000-00002

Cited by 23 publications

(13 citation statements)

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“…Skin breakdown and pressure ulcers [32,33] due to prolonged usage have been documented in some patients particularly at the main contact points at the mandible, occiput, ears, shoulders, and clavicles. Prior studies have demonstrated that these complications may be reduced or eliminated with appropriate choice of newer, improved orthotics, an appropriate skin care regimen and monitoring, and proper fitting and application of the orthoses [34][35][36]. Prolonged or over-usage of orthotics combined with inactivity may weaken spinal muscles [8].…”

Section: Discussionmentioning

confidence: 99%

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Ivancic

2012

Eur Spine J

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Purpose Our objectives were to develop a skull-neckthorax model capable of quantifying spinal motions in an intact human cadaver neck with and without cervical orthoses, determine the effect of orthoses on three-dimensional load-displacement properties of all cervical spinal levels, and compare and contrast our results with previously reported in vivo data. Methods Load input flexibility tests were performed to evaluate two cervical collars (Vista Ò collar and Vista ÒMultipost collar) and two cervicothoracic orthoses (CTOs: Vista Ò TS and Vista Ò TS4) using the skull-neck-thorax model with 10 intact whole cervical spine specimens. The physiologic range of motion (RoM) limit was the peak obtained from flexibility tests with no orthosis. Pair-wise repeated measures, analysis of variance (p \ 0.05), and Bonferroni post hoc tests determined significant differences in average peak RoM at each spinal level among the experimental conditions. Results Significant reductions below physiologic limits were observed due to all orthoses in: three-dimensional head/T1 RoMs, all sagittal intervertebral RoMs, and lateral bending at C4/5 through C7/T1. Both CTOs significantly reduced C6/7 sagittal RoM as compared to both collars. Intervertebral RoMs with the orthoses could not be differentiated from physiologic limits at the upper cervical spine in lateral bending and throughout the entire cervical spine in axial rotation, with the exception of C1/2.Conclusions Our results indicate that cervical orthoses effectively immobilized the entire cervical spine in flexion/ extension and the lower cervical spine in lateral bending. The CTOs improved immobilization of the lower cervical spine in flexion/extension as compared to the collars. The orthoses were least effective at restricting lateral bending of the upper spinal levels and axial rotation of all spinal levels, except C1/2. Understanding immobilization provided by orthoses will assist clinicians in selecting the most appropriate brace based upon patient-specific immobilization requirements.

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Section: Discussionmentioning

confidence: 99%

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Ivancic

2012

Eur Spine J

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“…26Y29 Three of the nine experimental studies examined the effect of C-spine immobilization devices: Stifneck, Philadelphia, Aspen, Miami-J (Ö ssur, Reykjavik, Iceland), and Newport (Aspen medical products) on TIP 30,32,33 comfort, 33 range of motion, 32 skin humidity, and skin temperature. 30 Sample sizes varied from n = 10 to n = 73. One study used a randomized block design, 25 and eight studies used crossover designs, 26Y33 of which five used randomization.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…One study used a randomized block design, 25 and eight studies used crossover designs, 26Y33 of which five used randomization. 27,29,30,32 Length of time in C-spine immobilization devices or on spinal immobilization devices varied from 5 minutes to 80 minutes and was not described in two studies. 32,33 Washout times varied from 5 minutes to 60 minutes and were not described in three studies.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Of the 13 included studies, seven scored 70.2% or more of the maximum grand total RAC scores, indicating superior quality; 21,23,25,27,29,30,32 the other six studies scored between 45.6% and 66.2% of the maximum total scores, indicating average quality 22,24,26,28,31,33 (Table 3).…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…Powers et al 22 described days in a C-collar ( p G 0.0001) and the length of time spent in a Stifneck C-collar as significant risk factors (no figures available). Powers et al 22 30 compared the Philadelphia and Aspen C-collar and examined the effect on skin humidity and skin temperature in healthy volunteers. They found a significant increase of skin humidity and temperature in the Philadelphia C-collar ( p G 0.0001).…”

Section: Risk Factors For Pu Developmentmentioning

confidence: 99%

See 2 more Smart Citations

Pressure ulcers from spinal immobilization in trauma patients

Ham

Schoonhoven

Schuurmans

et al. 2014

Journal of Trauma and Acute Care Surgery

100

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Spinal immobilisation for trauma patients

Kwan

Bunn

Roberts

2001

Cochrane Database of Systematic Reviews

171

139

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Background Spinal immobilisation involves the use of a number of devices and strategies to stabilise the spinal column a er injury and thus prevent spinal cord damage. The practice is widely recommended and widely used in trauma patients with suspected spinal cord injury in the prehospital setting. Objectives To quantify the e ect of di erent methods of spinal immobilisation (including immobilisation versus no immobilisation) on mortality, neurological disability, spinal stability and adverse e ects in trauma patients. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Injuries Group's specialised register, MEDLINE, EMBASE, CINAHL, PubMed, National Research Register and Zetoc. We checked reference lists of all articles and contacted experts in the field to identify eligible trials. Manufacturers of spinal immobilisation devices were also contacted for information. Searches were last updated in July 2007. Selection criteria Randomised controlled trials comparing spinal immobilisation strategies in trauma patients with suspected spinal cord injury. Trials in healthy volunteers were excluded. Data collection and analysis We independently applied eligibility criteria to trial reports and extracted data. Main results We found no randomised controlled trials of spinal immobilisation strategies in trauma patients. Authors' conclusions We did not find any randomised controlled trials that met the inclusion criteria. The e ect of spinal immobilisation on mortality, neurological injury, spinal stability and adverse e ects in trauma patients remains uncertain. Because airway obstruction is a major cause of preventable death in trauma patients, and spinal immobilisation, particularly of the cervical spine, can contribute to airway compromise, the possibility that immobilisation may increase mortality and morbidity cannot be excluded. Large prospective studies are needed to Spinal immobilisation for trauma patients (Review)

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Comparative Study of Risk Factors for Skin Breakdow With Cervical Orthotic Devices

Abstract: Aspen resulted in lower relative skin humidity.

Cited by 23 publications

References 0 publications

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Effects of orthoses on three-dimensional load–displacement properties of the cervical spine

Pressure ulcers from spinal immobilization in trauma patients

Spinal immobilisation for trauma patients

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