Suffering from an unexpected spinal cord injury, which commonly results from a sudden, traumatic impact on the spine that fractures or dislocates vertebrae, is a devastating and permanent condition. Not only do the victim become immobile and lose their regular motor function, but they are also highly susceptible to psychological distress, skyrocketing debt, and additional health issues stemming from the injury.
One of the most pressing health issues is the occurrence of pressure ulcers – which are a serious complication for people with spinal cord injury (SCI). Pressure ulcers and their medical treatment represent one of the most challenging clinical problems faced by spinal cord injury victims or persons who are neurologically impaired.
What is a pressure ulcer?
Pressure ulcers, also called decubitus ulcers, bedsores, or pressure sores, range in severity from skin reddening to severe, deep craters with exposed muscle or bone. Pressure ulcers significantly threaten the well-being of spinal cord injury victims. Pressure ulcers are a lifelong and traumatic complication of spinal cord injury. Pressure ulcers have the potential to no doubt interfere with a victim’s physical, psychological, and social well-being and can negatively impact overall quality of life.
A pressure ulcer is essentially a bed sore or damaged skin that occurs when an area of the skin has undergone prolonged pressure, such as when an individual is sitting still for a long period of time. Generally, they are caused by a lack of blood flow to one area of the skin as a result of that pressure. Anything that adds pressure to the skin, such as a zipper on a piece of clothing, could also contribute to the formation of a pressure ulcer.
People who are in the hospital for prolonged periods of time are susceptible to pressure ulcers because of their lack of mobility. In fact, 26% of patients in Canadian hospitals experience pressure ulcers in the clinical setting.
For this reason, spinal cord injury victims are also particularly susceptible to pressure ulcers because of the nature of sitting in a wheelchair for the majority of the day. Additionally, these individuals are more likely to have lower blood circulation due to the nerve damage they have suffered, rendering them more likely to experience inadequate blood flow to an area.
How do I know if I have a pressure ulcer?
A patch of red skin is the most distinguishable feature of a pressure ulcer. If the redness does not go away when the pressure is removed from the area, this is the initial stage of a pressure ulcer. At this point, it is essential to relieve the pressure. At some point, the affected area will become an open wound that exhibits similar features to a blister. It will become more painful as it progresses. Next, the skin around the wound may break, which can cause the fluids in the wound to seep out. During this time, the wound and surrounding area will still be red, but it may no longer be painful.
When this stage worsens, the wound will become deeper and deeper. It may reach all the way down to the individual’s bone tissue or muscles. At this point, it will have penetrated deep enough to cause a serious infection or other complications.
Why are spinal cord injury pressure ulcers potentially dangerous?
When you have suffered a spinal cord injury, you have suffered damage to your central nervous system. Loss of sensation in your lower body means that you cannot feel pain or temperature in the affected area, and as a result, you are unaware that you have obtained a pressure ulcer. This makes it more complicated to notice, and often, it has become a serious wound by the time the individual does notice.
Pressure ulcers cause many potential complications. They can lead to sepsis, cancer (squamous cell carcinoma), cellulitis, or severe infection if they do not heal properly. For spinal cord injury victims who are suffering from limited blood circulation and delayed motor functions, this could be fatal as the body is not always prepared to fight off these conditions.
How are spinal cord injury pressure ulcers treated?
Once someone has developed a pressure ulcer, immediate medical treatment is recommended. If you discover that you are suffering from a pressure ulcer, the most important step to take is to relieve the pressure from the area. For many individuals, this means going on bed rest until the wound begins to heal. This keeps the pressure off the area for a longer period of time, allowing the wound to recover safely.
Pressure ulcer treatment can involve non-operative wound care using solutions, ointments, creams, dressings, topical or mechanical debridement, and electrical stimulation. Depending on the pressure ulcer stage, surgery may be required in some cases.
The stages of the pressure ulcer are described in the attached .pdf medical journal, “Comprehensive Management of Pressure Ulcers in Spinal Cord Injury.” Surgery can take the form of surgical debridement, direct wound closure, skin grafts, or skin, fasciocutaneous, or myocutaneous flaps.
Prevention and Management Suggestions
The most important thing for a spinal cord injury victim to do is to remain proactive and take preventative measures to avoid obtaining pressure ulcers. This could mean changing the way that you transfer to and from your wheelchair or ensuring that you shift your position every so often.
The following tips offer reliable advice to help manage pressure and prevent pressure ulcers as effectively as possible:
- Stay hydrated to help blood flow
- Monitor body temperature in areas with lost sensation
- Smooth out bedsheets to remove wrinkles
- Position feet on footrests to relieve thigh pressure
- Make sure your clothes do not have thick seams, zippers or buttons on your skin
- Avoid clothes that are too tight
- Avoid clothes that are too loose, which can bunch up or wrinkle
- After going to the bathroom, ensure that the area is clean right away and use creams to protect your skin
- Ensure to use a wheelchair that is the right size for you
- Try to sit on a foam or gel seat cushion that properly fits your wheelchair
- Try to shift your weight in your wheelchair every 15 to 20 minutes to maintain blood flow
- In bed, use a soft pillow between parts of your body that presses up against each other or your mattress
- Try and use a pillow between your knees, under your heels, calves, tailbone, shoulders or elbows if necessary
- Try NOT to put a pillow under your knees as it places pressure on your heels
- Do not drag yourself into bed; have someone help lift you if possible
- Change positions every few hours to relieve pressure off of one spot
- Try and lay flat – lying with your head too high might cause your body to slide – which can be harmful
Have you suffered a traumatic spinal cord injury?
Suffering a spinal cord injury is no doubt a devastating condition that leads to significant neurological impairment, reduced quality of life, and significant personal and sociological losses and is a serious disorder that has a profound impact on a victim’s physical and psychosocial well-being.
At Lalande Personal Injury Lawyers, we take pride in being trusted Hamilton personal injury lawyers since 2003. Over the years, we’ve helped our clients recover more than $45 Million in settlements and verdicts in personal injury, disability, and employment law cases. Whether you’re dealing with a life-changing injury, a denied disability claim, wrongful death, a hurt child or employment termination, we are here to provide compassionate and experienced legal representation. If you believe you have a case, call us today—we’re ready to help you secure the compensation you deserve.
Call Lalande Personal Injury Lawyers today, no matter where you are in Ontario at 905-333-8888 for your free consultation. Alternatively, you can contact us online, confidentially, by filling out a contact form.