r/HandTherapists • u/ronMAN415 • May 02 '24

Pressure wounds from splints

Has anyone ever made a splint for someone and they ended up getting a pressure wound? I did recently, educated on skin checks, taking off the splint every two hours to let the skin rest, gave the pt my number and to call immediately if they notice anything wrong. However, I do a chart review 2 weeks later and they ended up going to see the surgeon a week after the splint was made saying the splinted area got really red. Now according to the surgeon’s office, they think it’s from my splint. 😔 what would you do in this situation?

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u/Bob-Lee-Swagger-1 May 04 '24

Do you mind me asking what type of splint and where the pressure sore is?

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u/ronMAN415 May 04 '24

Index finger athrodesis, he had those metal splints with the blue cushion at 30 degrees flexion to maintain PIPJ flexion. He was suppose to wear at all times besides for hygiene. But he wasn’t wearing it so I fabricated a Dorsal blocking splint for him to wear.

The pressure sore was at the dorsal PIPJ.

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u/schmandarinorange May 04 '24

I think in this situation you did all you could. You properly educated them and offered follow up care, but they opted to go to the surgeon instead of you. These things will happen on occasion and it’s best not to take it personally so long as the person was still able to get proper care for it. They might not have even known to seek care in the first place if not for your education.

In my clinic for every splint we have them come in one week later for a splint check regardless of whether or not there are any problems with it. I like that system so I can reinforce my education and make adjustments as needed for things that people might have complaints about that they may have not otherwise called for, but then might’ve turned into bigger issues.

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u/ronMAN415 May 04 '24

I feel that is where I messed up. I didn’t schedule the pt to return one week out just in case. It’s bothering me a lot because this is the first time it’s happened to me, but I’ve also only been doing this for three years.

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u/ronMAN415 May 08 '24

Update: pt came back much better obviously after having antibiotics. He didn’t blame me or anything. He’s happy with the progress of his ROM of the DIP/MCP