Living With a Spinal Cord Injury - Pressure Sores
When you have a spinal cord injury,
the nerves that normally signal discomfort and alert you to relieve pressure by
changing position may no longer work. This can cause pressure sores, which are injuries to the skin and the tissue under the skin. They often develop on skin that covers
bony areas , such as the hips, heels, or tailbone. Pressure sores can also occur in places where the skin folds over on itself. They are described in four
stages that range from mild
reddening of the skin to severe
complications, such as infection of the bone or blood. They
can be hard to treat and slow to heal.
Pressure sores may be caused by:
- Constant pressure on the
skin, which reduces blood supply to the skin and to the tissues under the skin.
- Friction, which is the rubbing that
occurs when a person is pulled across bed sheets or other surfaces.
which is movement (such as sliding down a chair) that causes the skin to fold
over itself, cutting off the blood supply.
- Irritation of the skin from things such as sweat, urine, or feces.
Pressure sores are usually diagnosed with a physical exam.
skin and wound culture or a
skin biopsy may be done if your doctor thinks you may
have an infection.
Preventing pressure sores
You or your caregiver
can help prevent pressure sores. These steps can help keep skin healthy:
- Prevent constant pressure on any part of the body.
- Change positions and turn often to help reduce constant pressure on the skin. Learn the proper way to move yourself or to move a person you are caring for so that you avoid folding and twisting skin layers.
- Spread body weight. Use pressure-relieving supports and devices, especially if your are confined to a bed or chair for any length of time, to help prevent pressure sores. Pad the metal parts of a wheelchair to help reduce pressure and friction.
- Avoid sliding, slipping, or slumping, or being in positions that put pressure directly on an existing pressure sore. Try to keep the head of a bed, a recliner chair, or a reclining wheelchair raised no more than 30 degrees.
- Eat a balanced diet
that includes plenty of protein.
- Keep the skin clean and free of body fluids or feces.
- Use skin lotions to keep the skin from drying out and cracking, which makes the skin more likely to get pressure sores. Barrier lotions or creams have ingredients that can act as a shield to help protect the skin from moisture or irritation.
For more information on prevention,
see the topic
Signs to look for
Watch for early signs of
a pressure sore. These can include:
- A new area of redness that doesn't go away within a few minutes
of taking pressure off the area.
- An area of skin that is warmer or cooler than the surrounding
- An area of skin that is firmer or softer than the skin around
Contact your doctor if you:
- Think a pressure sore is starting and you aren't able to adjust
your activities and positioning to protect the area.
- Notice an increase in the size or drainage of the sore.
- Notice increased redness around the sore or black areas starting
- Notice that the sore begins to smell bad and/or the drainage
becomes a greenish color.
- Have a fever.