Page 19 - Mobility Management, July/August 2022

zero. It cannot be; it’s never going to be the same.”
That’s because skin and tissues never fully regain the function they had before injury. “It is not elastic,” Giles said of that skin. “It does not release oils.”
Giles said she also needs to know about Stage 1 and 2 injuries: “Those are docu- mented wounds; those are areas of skin that are showing signs of lower life. Some cells are dying. The metabolic systems
of those cells are different than the ones around them, and I want to know about that.”
Giles said she routinely asks seating clients, “‘Is there an area that you worry about? Is there an area that your caregiver says ‘ugh’ about?’ Those are [Stage] 1’s and 2’s, and those are often not classified professionally. The patient doesn’t know that’s a wound. So I’ll say, ‘Are there any areas that you carefully watch or that are
sometimes iffy?’”
She also pointed out that if, for
example, a client has had flap surgery, orthopaedic interventions might have occurred. “[The patient has infection, so they’ll shave the IT [ischial tuberosity],” Giles said as a surgical example. “The IT should not be this shape; this is like a dagger. So I want to see it, and I want to feel it. I don’t trust the charts.”
Sitting Upright While Healing
If a wheelchair user has a wound in an area that would be in contact with the seat cushion — can the client sit in a wheel- chair while healing?
Yes, if the right precautions are taken, Giles said, adding that physicians she’s worked with have even prescribed upright sitting as part of the healing course.
“Historically, all we’ve had is side-lying in bed,” Giles said, describing previous
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