How to Identify and Prevent Pressure Sores After a Spinal Cord Injury?

 

Patients with a spinal cord injury fight a battle every day to bring mobility back into their lives. But this doesn’t mean that complete mobility is a lost cause. Advanced methods such as Stem Cell Therapy and neurorehabilitation have made complete recovery a possibility for patients with spinal cord injuries. 

While patients focus on regaining muscle strength, they tend to forget about one injury that can be caused post the treatment of spinal cord injury (SCI) — pressure injuries.

What are pressure injuries?

These injuries are caused by restricted blood flow under the skin that leads to tissue damage. Patients with SCI are very likely to develop pressure injuries during their treatment phase. About one-third of patients with new SCI develop pressure ulcers during their initial hospitalization phase.

How to identify pressure injuries?

People with an SCI should check their skin daily for the following:

• Color changes red, purple, pink, or blue
• Temperature/texture changes; cracked, dry, soft, warm, or cool spots
• Scrapes, cuts, bruises, swelling, or blisters
• Itchy or painful spots 

Causes of pressure injuries

SCI damages the sensory nerves causing little to no feeling in certain muscles. So patients are unable to identify the pressure subjected to the skin due to long sessions of sitting or lying down in one position. This is the general cause of pressure injuries. Now let’s look at some specific causes. 

Pressure 

An SCI patient can experience tissue damage irrespective of the amounts and duration of pressure. Some activities that patients should be wary of are:

• Low-pressure activities over a long period such as sitting in one place for one to six hours
• Frequent, high-pressure activities such as bumping elbows against a table, desk, or armrest multiple times in a day 
• High-pressure accidents such as bumping against a hard surface 

Shear

Skin damage can happen even when patients drag themselves across a surface causing unnecessary friction. For instance, friction between a patient’s clothes and a bed/wheelchair.

Position

Habits such as putting weight on one side of the body can lead to pressure injuries to certain bony areas of the body.

Skin moisture and maceration

When skin is exposed to moisture for a long duration, it can soften and weaken — making it vulnerable to damage. For a patient with SCI, excessive sweat, exposure to urine and feces due to incontinence, can be the cause of skin maceration and thus pressure injuries.

Why should you be wary of pressure injuries?

• Increased hospitalization time — As many as 34% of people with an SCI end up requiring three or more hospitalizations throughout their lifetime for treating pressure ulcers

• Increased dependence — People with pressure injuries need to rely on others for even basic activities such as sitting up, lying down, etc. since muscle movement is often painful.

• High expenses — For a patient with SCI, over 25% of medical expenses are related to pressure sores. 

• Fatal — About 7-8% of deaths in the SCI population are related to pressure injuries. 

Pressure sores are fatal if they lead to an infection known as sepsis in the blood and tissues.

How to prevent pressure injuries?

• Switch position frequently —While seated in a bed or wheelchair, change your position every 15 minutes. Also while shifting positions prevent rubbing by lifting your body and avoid dragging
• Conduct regular skin checks — Observe and feel the skin each morning and evening to identify any signs of pressure injuries. Check areas where bones are close to the skin surface.
• Keep skin clean and dry — Avoid continuous contact with water or moisture by wiping off body sweat or excessive fluids after a bowel or bladder accident. 
• Use the right equipment —Use mattresses and wheelchairs that are in a good condition and can distribute weight evenly. 

• Perform pressure relief exercises — Take 15 minutes a day to perform simple exercises like crossing your legs, lifting yourself off, leaning forward, leaning side to side, etc.

Treatment of pressure injuries

The treatment of pressure injuries depends on the size and stage of the injury. In most cases treatment involves, 

• Using special wound cleansers and dressings
• Removing dead tissue from the wound 
• Taking antibiotics to heal the infection
• Undergoing surgery (in extreme cases) to close the wound
• Improving oxygen flow to the damaged tissue via a hyperbaric chamber 

At Plexus, we conduct Stem Cell Therapy treatment of spinal cord injury. We also have a holistic Regenerative Rehabilitation Program that helps patients lead pain-free, fulfilling life. Some of the treatment methods used in this program are oral and intravenous medications, physiotherapy, occupational therapy, speech therapy, acupuncture, therapeutic massages, etc. Additionally, we take all preventive measures to ensure pressure injuries aren’t developed in our patients.

Patients must not fear Stem Cell Therapy treatment of spinal cord injury as it is one of the most effective methods available out there. Before, during, and after the therapy, patients must also be wary of developing pressure injuries. Pressure injuries are usually detectable and avoidable by taking just a few measures — so, monitor your skin, keep the pressure off, and don’t let injuries hinder your path to complete recovery.