Rintala et al. 2008
USA
PEDro=6
RCT
N=41
N(SCI)=39
N(MS)=2

Population: Age=29-78yrs; Gender: males; Level of injury: cervical=39%, thoracic=56%; Severity of injury: complete=68%
Treatment: SCI and MS patients receiving surgical repair of a stage III or IV pressure ulcer were randomized into 3 groups: Group1: received an enhanced education and monthly structured follow-up intervention (via telephone) for 2 years after discharge; Group2: received monthly contacts (via mail) for up to 2 years after discharge to assess skin status, but no education; Group3: received minimal contact by mail every 3 months for up to 2 years after discharge to assess skin status but no education.
Outcome Measures: Recurrence of pressure ulcers or 2 years after discharge.

1. Group 1 had a significantly longer time before recurrence of pressure ulcers than other groups, p=0.002; while no sigificant difference was seen between group 2 and 3.
2. Individuals were ulcer free longer if many years had passed since their last surgery.
3. Health status had no significant effect on staying ulcer free.
4. For those with no previous ulcer surgery, persons in Group 1 were ulcer free longer than those in group 2 or 3 (19.6 vs. 10.1 or 10.3 months).
5. 1/3 of Group 1 (33.3%) had ulcer recurrence during study compared to group 2 (60%) and group 3 (90%).,

Garber et al. 2002
USA
PEDro=5
RCT
N=41
N(SCI)=39; N(MS)=2

Population: Mean age = 53 yrs; Gender: males = 41; AIS: A = 28, B = 10, D = 1. MS=2; Time since injury = 17 yrs.
Treatment: SCI and MS patients receiving surgical repair of a stage III or IV pressure ulcer were randomized into an intervention group (N=20) and control group (N=21). Intervention group: 4 1-hr enhanced education sessions dealing with management and prevention of pressure ulcers and structured follow-up (monthly telephone contact regarding skin status and use of prevention behaviours). Control group: Standard educational information given with no structured follow-up (periodic telephone contact to address skin status only). All subjects followed for 2 years after discharge or until recurrence of pelvic pressure ulcer.
Outcome Measures: Demographic and health information questionnaire; Pressure ulcer knowledge test; Health beliefs questionnaire; Multidimensional health locus of control scale.

1. At discharge, both groups had an improvement on the pressure ulcer knowledge test, but more pressure ulcer knowledge was acquired within the intervention group (p<0.03).
2. At discharge, no notable differences were found on the health beliefs questionnaire and the multidimensional health locus of control scale.
3. Even though both groups remembered pressure ulcer knowledge obtained 2 yrs prior, the intervention group maintained a higher level of pressure ulcer knowledge (68%) than did the control group (60.8%) at 2 yrs post-discharge.