Integumentary Essentials: Applying the Preferred Physical Therapist Practice Patterns[SM].

Integumentary Essentials: Applying the Preferred Physical Therapist Practice Patterns[SM] Moffatt M, ed; Biggs Harris K, associate ed. Thorofare, NJ 08086, Slack Inc, 2006, paperback, 160 pp, illus, ISBN: 1-55642-670-4; $50.95.

This book is 1 of a series of 4 books (Musculoskeletal Essentials, Neuromuscular Essentials, Cardiovascular Essentials, and Integumentary Essentials) that are designed to help physical therapists, physical therapist assistants, and students use the American Physical Therapy Association's Guide to Physical Therapist Practice (Guide). Integumentary Essentials uses patient cases to illustrate the application of the patient/ client management model to each of the 5 integumentary system practice patterns. The first chapter addresses the prevention and risk reduction for integumentary disorders practice pattern. Chapters 2 through 5 cover the other integumentary practice patterns that are based on depth of tissue loss.

Each chapter begins with a review of the pertinent anatomy, physiology, pathophysiology, imaging, and pharmacology related to each practice pattern. Following this excellent review, the reader is led through 3 cases where the patients/clients vary in age, diagnosis, functional level, cause of injury, practice setting, general health, and social support. For example, cases in the primary prevention practice pattern include a patient with rheumatoid arthritis and an elderly individual in skeletal traction. The sample cases in chapters covering the practice patterns dealing with depth of tissue loss include a patient with a cerebrovascular accident and a pressure area, a patient with mixed vascular disease and a pressure ulcer, a patient with a neuropathic wound, and a patient who received free flap reconstruction of an electrical wound.

Each case is presented in the Guide format, using the 5 patient/ client management elements: examination, evaluation, diagnosis, prognosis, and intervention. Each element section is clearly written and is exceptionally complete. The intervention section for each case suggests several management strategies. The authors provide the reader with the rationale for each selected intervention and provide an evidence base for the selected interventions in the form of an extensive reference list. A case management approach is utilized in the intervention section of each case through the use of a "Coordination, Communication, and Documentation" section, in which the chapter authors consistently promote the collaboration of the physical therapist with other health care professionals. For each case, possible patient referrals and specific communication methods among the patient, physical therapist, physician, and other health care professionals are suggested.

The tables are well organized and contain numerous assessment and classification scales, laboratory reference values, and explanations and methodology of various tests and measures, as well as bulleted item summaries of pertinent information. However, the photographs in the 3 cases presented for each practice pattern are in black and white and are not of the highest quality with respect to clarity and detail. There is a color atlas section in the book if the reader wishes to view the same pictures in color, which necessitates flipping back and forth between the text and the more realistic and vivid color photographs. Each chapter is well referenced and provides the reader with additional literature for further information.

In summary, the text meets the needs of students and both beginning and experienced clinicians who want to integrate the parameters of the Guide into the integumentary practice area. It will serve as a wonderful addition to the physical therapy wound management texts currently available.

Thomas Hudson

T Hudson, PT, PCS, is Assistant Professor, Doctor of Physical Therapy Program, Gannon University, Erie, Pa.

[DOI: 10.2522/ptj.2007.87.5.613.2]