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Spinal Cord Injury (SCI) and Pressure Ulcers

Spinal Cord Injury & Pressure Ulcers

A quick summary from Hamilton spinal cord injury lawyers:

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.

What is a pressure ulcer?

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.

How do I know if I have a pressure ulcer?

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.

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 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.

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 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.

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 foot rests 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 and 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 in 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 to 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, 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.

*This information has been obtained from our experience and knowledge of spinal cord injury law as well as Medical Peer Reviewed Journals and Medical Studies from SCIRE (Spinal Cord Injury Research Evidence), Pubmed and



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