Living With a Spinal Cord Injury (cont.)
IN THIS ARTICLE
Pressure sores (bed sores) are an injury to the skin and the tissue under the skin. They are a frequent and sometimes serious complication of a spinal cord injury (SCI). They can range from mild reddening of the skin to severe complications, such as infection of the bone (osteomyelitis) or blood (sepsis). They can be hard to treat and slow to heal.
In people with SCIs, the nerves that normally signal discomfort and alert you to relieve pressure by changing position may no longer work. It is important for you to pay attention to possible pressure sores and change your position frequently when you are sitting or lying down.
Pressure sores are usually caused by unrelieved pressure. They often develop on skin that covers bony areas (such as the hips, heels, or tailbone). Constant pressure on the skin reduces blood supply to the skin and to the tissues beneath the skin. Oxygen and nutrients carried by the blood cannot reach the cells in the tissue, eventually causing cell death, breakdown of the skin, and a pressure sore.
Other causes may include friction, which is the rubbing that occurs when a person is pulled across bed sheets or other surfaces, and shear, which is movement (such as sliding down a chair) that causes the skin to fold over itself, cutting off the blood supply and possibly causing pressure sores.
You or your caregiver can help prevent pressure sores by using proper pressure-relieving supports and devices and changing your position frequently, whether you're in a bed or a wheelchair. You can also help prevent pressure sores if you avoid smoking, eat a balanced diet that includes plenty of protein, and control your weight. For more information, see the topic Pressure Sores.
Watch for early signs of a pressure sore. These can include:
Contact your doctor if you:
General treatment for pressure sores is to keep the area dry and clean, eat well, and reduce pressure. All pressure sores need to be treated early, because after a sore progresses to stage 3 or 4, it is hard to treat and can lead to serious complications. Specific treatment depends on the stage of the pressure sores.
As you treat a pressure sore, you will know it is healing correctly if:
After a pressure sore is healed, it is important to gradually put pressure on the area where the sore had been.
Note: Pressure sores can trigger autonomic dysreflexia, a syndrome in which there is a sudden onset of very high blood pressure and headaches. If not treated promptly and correctly, it may lead to seizures, stroke, and even death. Although autonomic dysreflexia rarely leads to these more serious complications, it is important to know the symptoms and watch for them. Autonomic dysreflexia is more common in people with an injury to the thoracic nerves of the spine or above (T6 or above).
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