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 does the victim become immobile and lose their regular motor function, 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 ulcer – 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.
Pressure ulcers, also called decubitus ulcers, bedsores, or pressure sores, range in severity from reddening of the skin 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 the lack of mobility and movement they are experiencing. 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.
The most distinguishable feature of a pressure ulcer is a patch of red skin. 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 would to seep out. During this time, the wound and its 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.
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 are unable to 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 by the time the individual does notice, it has become a serious wound.
There are many potential complications caused by pressure ulcers. 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.
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 be non-operative care of the wound by using solutions, ointments, creams, dressings, topical or mechanical debridement, and electrical stimulation. In some cases, surgery may be required, depending on the stage of the pressure ulcer.
The stages of the pressure ulcer can be found in the attached .pdf medical journal entitled “Comprehensive Management of Pressure Ulcers In Spinal Cord Injury.” Surgery can be in the form or surgical debridement, direct wound closure, skin grafts, and skin, fasciocutaneous, or myocutaneous flaps.
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:
Suffering a spinal cord injury is no doubt a devastating condition that leads to significant neurological impairment, reduced quality of life, significant personal, sociological losses and is a serious disorder that has a profound impact on a victim’s physical and psychosocial well-being. If you have suffered a traumatic spinal cord injury contact us today at 905-333-8888 or message through our online contact form to get in touch with us and learn more about how we can be of valuable assistance to you – your recovery and your family.