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Pressure Sores, Pressure Ulcers or Decubitus Ulcers

Spinal Cord Injury Pressure Sores Sections

Spinal Cord Injury Pressure Sores

Pressure sores must be taken seriously, if left unchecked, a pressure sore can lead to amputation or in the worst case death. Even when well cared for, a pressure sore can still become infected such as was the case with Christopher Reeve in October 2004. Christopher had the best care and was looked after by dedicated staff at Northern Westchester Hospital, but still his sore became severely infected, resulting in a serious systemic infection. This in turn led to a heart attack and coma from which he did not recover. Check yourself for red marks and sores daily, it should be a routine which is as second nature as brushing your teeth.

Causes of Pressure Sores

A pressure sore, also known as a bed sore, is an injury to the skin and the tissue under it. A pressure sore develops when the blood supplying the tissue with oxygen and nutrients is cut off, and the tissue no longer receiving oxygen and nutrients dies. The oxygen and nutrients are essential to maintain healthy tissue. Sitting in the same position for a prolonged period of time can start the process of tissue breakdown.

People who smoke are also at an increased risk of developing a pressure sore due to reduced blood flow to the skin. Those who are overweight or diabetic are also at increased risk.

Prevention of Pressure Sores

If you have been paralyzed, you may not feel a pressure sore developing, therefore it is essential to change your position on regular intervals to allow the circulation of blood throughout pressured areas. Normally in an able bodied person, if you are uncomfortable in your seating position, messages from nerves in the skin will be sent via your spinal cord to the brain to indicate discomfort. However in a person with a spinal cord injury, these messages are blocked at the level of injury, and the disabled person may not even be aware at the level of potential damage the skin is in.

Types of Pressure Sore

Pressure sores are also be referred to as pressure ulcers or decubitus ulcers. The damage from a pressure sore will range from slight discoloration of the skin (stage 1) to open sores that go all the way to the bone (severe). The affected area may feel warmer than the surrounding tissue. In light-skinned people, the discoloration may appear as dark purple or red. In darker-skinned people, the discoloration will appear darker than the surrounding tissue.

Stage One Pressure Sore

How to recognise: Skin is not broken but is red or discolored. The redness or change in color does not fade within 30 minutes after pressure is removed. The hardness or firmness (with an edge you can feel) is called induration and is one of the most common signs of a stage I pressure ulcer.

NEVER massage over a pressure ulcer like this. It will increase the damage and can cause it to progress to an open (stage II or deeper) pressure ulcer.

Bed Pressure Sore

Stage Two Pressure Sore

How to recognise: The epidermis or topmost layer of the skin is broken, creating a shallow open sore. Drainage may or may not be present.

Pressure Ulcer

Stage Three Pressure Sore

How to recognise: The break in the skin extends through the dermis (second skin layer) into the subcutaneous and fat tissue. The wound is deeper than in Stage Two.

Decubitus Ulcer

Stage Four Pressure Sore

How to recognise: The breakdown extends into the muscle and can extend as far down as the bone. Usually lots of dead tissue and drainage are present.

Decubitus Sore
Skin Breakdown

If the skin is at stage 1, the red area can be healed by keeping the pressure off the affected area. If the sore does not heal in a few days or recurs, consult your health care provider.

If the skin is thought to be at stages 2 - 3, you should consult your health care provider for further treatment.



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