My Scope of Practice: A Physical Therapist`s Role in Wound Care

Renee Cordrey, PT, PhD(c), MSPT, MPH, CWS has a two-pronged passion for wound care. First is the challenge and complexity involved in caring for people with wounds. “I love thinking about the science of wound healing and learning more all the time,” Renee says. “I love how I can use that knowledge to make a difference in people’s lives, both at an individual and at a facility level.” Second is interacting with her patients. “Because some wounds take time to heal, I get to enjoy a long-term relationship with my patients, seeing them frequently and sometimes multiple times a week for a half hour or more,” she says. “With that, I love the smiles, the sincere moments shared, and the hugs that come along with success.”

People do not always understand the benefit physical therapy brings to the wound healing team. Renee explains that in addition to direct wound care, including sharp debridement, PTs may incorporate therapeutic modalities to promote healing through stimulating cellular activity and address the functional impairments common to people living with a chronic wound that contribute to as well as result from the wound.

Renee earned her bachelor degree in Health Studies and her Masters in Physical Therapy from Boston University (Boston, MA). During her first clinical affiliation (Methodist Hospital, Houston, TX), she was exposed to wound care and quickly grew to love the practice area. “In those days, we mostly used whirlpools with everyone,” she says. “What caught my interest was the physiology of wound healing and the ability to see a change so quickly. What has kept me interested is the rapid growth of the field and the paradigm shifts we’ve gone through. When I started, the focus was on the macro level — what kinds of tissue were in the wound and how much exudate was there. Then we began to look more systemically, considering nutrition, circulation, external forces. Now, we’re looking at a micro level, thinking about cytokines, biofilms, and pH. I can’t wait to see the next development.”

Inspired by one of her undergraduate professors, Renee went back to school a few years into her career to get her Masters in Public Health at the University of California (Los Angeles, CA). “My concentration in health education and health promotion helped me become a better PT, improving my patient education and helping me see the world with different eyes,” she says. “I started looking at issues much more systemically when evaluating a wound’s causative factors and the behavioral/lifestyle changes that can be made to promote healing, reduce recurrence, and improve prevention.”

Renee’s current wound care role involves direct patient care. In the past, she has been responsible for starting and managing an outpatient and inpatient program; coordinating all wound-related activities in a hospital, including patient care, staff education, policies, and quality and outcomes assessment; being a resource for staff in several long-term care facilities; training staff and assisting with consultations; and teaching in academic and clinical settings. In every role, she has worked closely with nurses, physicians, and therapists to achieve the best patient outcomes.

This interdisciplinary focus led Renee to the Association for the Advancement of Wound Care (AAWC). She has been a member for most of her career and is currently serving her fourth term on the Board of Directors. “With the growth in wound care knowledge has come the understanding that these patients are so complex no one discipline alone can meet all of their needs,” she says. “We need to work together. That teamwork has resulted in many significant contributions to the field, from guidelines to scholarships to global health initiatives to working for regulatory changes and so much more. The AAWC has many exciting projects in the works right now. I can’t wait to see them come to fruition.”

Renee is currently finishing her PhD in Physical Therapy (at Nova Southeastern University, Fort Lauderdale, FL) and hopes to incorporate more research into her practice, whether in the clinic or in academia. Regardless of the arena, Renee plans to continue to combine her knowledge of physical therapy and wound care. Asked what elicited her combined interest in physical therapy and wound care, Renee says, “There wasn’t a single case that hooked me in. Many patients have touched me at all points in my career. Very often they were going through a difficult time but graciously let me learn from their experience. I remember the man who got necrotizing fasciitis over half his chest and abdomen after a surgery and how we incorporated exercises for his exposed pectoral and abdominal muscles while he was in the Hubbard tank. I remember a WOCN at my first clinical site calling my supervising PT and telling her to send up her student because she had something interesting for me to see. I remember the man with Fournier’s gangrene on whom I learned to use pulsed lavage with the product rep and several other therapists in the room. I value the patients who have been honest with me, sharing their experiences living with a wound and their challenges in following the health care team’s recommendations.”

Renee expects her knowledge and abilities will continue to grow as the role of her specialty in wound care continues to evolve. She is confident that treating complex wounds and working closely with patients will fuel her scope of practice.

This article was not subject to the Ostomy Wound Management peer-review process.