Utilization of osteopathic manipulation treatment in healing of pressure ulcers

Authors

  • Chloe Bodden Department of General Surgery, Flushing Hospital Medical Center, New York, USA
  • Stevens Griner Department of General Surgery, Flushing Hospital Medical Center, New York, USA
  • Patrick Kiarie Saint George University Medical School, Grenada
  • Christina Sneed Saint George University Medical School, Grenada
  • Madiha Khan New York Institute of Technology College of Osteopathic Medicine, New York, USA
  • Ayda Khan New York Institute of Technology College of Osteopathic Medicine, New York, USA
  • Preet Sawhney New York Institute of Technology College of Osteopathic Medicine, New York, USA
  • Seth Williams Saint George University Medical School, Grenada
  • Andrew Miele MediSys Health Network, Queens, New York, USA
  • Martine A. Louis Department of General Surgery, Flushing Hospital Medical Center, New York, USA

DOI:

https://doi.org/10.18203/2349-2902.isj20243549

Keywords:

PUs, OMT, Noninvasive treatment, Healthcare cost burden, Wound management

Abstract

Pressure ulcers (PUs), caused by prolonged pressure on the skin and tissue, affect millions annually in the US, resulting in significant emotional and financial burdens for patients. The healthcare system bears a substantial cost burden annually, primarily due to stage 3 and 4 ulcers. Through noninvasive techniques, osteopathic manipulative treatment (OMT) targets lymphatic system dysfunction and homeostasis to expedite patient recovery, with documented applications in conditions such as low back pain, pneumonia, and lower extremity wounds by optimizing lymphatic flow. However, the potential of OMT in managing PUs still needs to be thoroughly explored. This pilot study involved lymphatic OMT performed three times a week on patients admitted with community-or healthcare-acquired sacral PUs present for at least one week. Ulcer growth rates were calculated based on volume at baseline and in the third week following the first manipulation. Each patient was provided descriptive comparisons of albumin levels, body mass index (BMI), and demographic data, including age, sex, and race. At week three, following the initiation of treatment, decreased ulcer volume based on growth rate was observed in 75% of patients in our OMT group compared to 25% of patients in our control group. Our OMT pilot study suggests that adding OMT to standard therapy is safe and feasible, and it may accelerate the healing rate of sacral PUs while decreasing the cost burden on the healthcare system.

References

Afzali BL, Albatineh AN, Hasanpour DA, Ghanei GR. The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A Systematic Review and Meta-Analysis. Int J Prev Med. 2020;11:171.

Mervis JS, Phillips TJ. Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol. 2019;81(4):881-90.

Gould LJ, Alderden J, Aslam R, Barbul A, Bogie KM, El Masry M, et al. WHS guidelines for the treatment of pressure ulcers-2023 update. Wound Repair Regen. 2023;32(1):6-33.

Anglund DC, Channell MK. Contribution of osteopathic medicine to care of patients with chronic wounds. J Am Osteopath Assoc. 2011;111(9):538-42.

Worsley PR, Crielaard H, Oomens CWJ, Bader DL. An evaluation of dermal microcirculatory occlusion under repeated mechanical loads: Implication of lymphatic impairment in pressure ulcers. Microcirculation. 2020;27(7):e12645.

Chen Z, Gleason LJ, Sanghavi P. Accuracy of Pressure Ulcer Events in US Nursing Home Ratings. Med Care. 2022;60(10):775-83.

Gaspar S, Peralta M, Marques A, Budri A, Gaspar de Matos M. Effectiveness on hospital-acquired pressure ulcers prevention: a systematic review. Int Wound J. 2019;16(5):1087-102.

National Clinical Guideline Centre (UK). The Prevention and Management of Pressure Ulcers in Primary and Secondary Care. London: National Institute for Health and Care Excellence (NICE). (NICE Clinical Guidelines, No. 179.). 2014.

Gillespie BM, Walker RM, Latimer SL, Thalib L, Whitty JA, McInnes E, et al. Repositioning for pressure injury prevention in adults. Cochrane Database Syst Rev. 2020;6(6):CD009958.

Serra R, Grande R, Buffone G, Gallelli L, Caroleo S, Tropea F, et al. Albumin administration prevents the onset of pressure ulcers in intensive care unit patients. Int Wound J. 2015;12(4):432-5.

Roberts A, Harris K, Outen B, Bukvic A, Smith B, Schultz A, et al. Osteopathic Manipulative Medicine: A Brief Review of the Hands-On Treatment Approaches and Their Therapeutic Uses. Medicines (Basel). 2022;9(5):33.

Flodine TE, Thomas M. Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction. Treasure Island (FL): StatPearls Publishing. 2023.

Lancaster DG, Crow WT. Osteopathic Manipulative Treatment of a 26-Year-Old Woman with Bell’s Palsy. J Am Osteopathic Assoc. 2006;106(5):285-9.

Goldstein M. Osteopathic manipulative treatment for pneumonia. Osteopath Med Prim Care. 2010;4(1):3.

Kilgore T, Malia M, Di Giacinto B, Minter S, Samies J. Adjuvant Lymphatic Osteopathic Manipulative Treatment in Patients With Lower-Extremity Ulcers: Effects on Wound Healing and Edema. J Am Osteopath Assoc. 2018;118(12):798-805.

Riquet D, Houel N, Bodnar JL. Effect of osteopathic treatment on a scar assessed by thermal infrared camera, pilot study. Complement Ther Med. 2019;45:130-5.

Lennon RP, Dong H, Zgierska AE, Demetriou T, Croad J, Livelsberger C, et al. Adjunctive osteopathic therapy for hospitalized COVID-19 patients: A feasibility-oriented chart review study with matched controls. Int J Osteopath Med. 2022;44:3-8.

Bowes MR, Speicher MR, Tran LT, Santiago PN. Osteopathic Manipulative Medicine and Its Role in Psychiatry. Cureus. 2023;15(10):e47045.

Sen CK. Human Wounds and Its Burden: An Updated Compendium of Estimates. Adv Wound Care (New Rochelle). 2019;8(2):39-48.

Downloads

Published

2024-11-27

Issue

Vol. 11 No. 12 (2024): December 2024

Section

Case Series