A spinal cord injury is the result of damage to the nerve tissue enclosed within the spine which relays messages between the brain and the rest of the body. Because of the importance of the spinal cord, damage to this tissue can cause a host of issues throughout the rest of the body. Pressure sores are a common repercussion of spinal cord injuries.
What is a pressure sore?
Pressure sores, which also referred to as bedsores, pressure ulcers or skin breakdown, are the result of an area of skin or underlying tissue that has been damaged due to the loss of blood flow. In order for the skin to be healthy, it needs a constant source of blood, otherwise it can become infected and even stop functioning completely.
After a spinal cord injury, the nerves in your skin which once allowed you to feel temperature and pain often no longer work, so these pressure sores can develop without you even knowing.
What causes pressure sores?
There are several potential causes of pressure sores. However, as the name suggests, the main source is excessive pressure on the skin without periods of relief. When you sit or lay for too long without movement, the blood flow is restricted to the areas experiencing pressure, resulting in tissue damage. Factors to be aware of include, not turning enough in bed, lack of proper padding, and sitting/laying upon surfaces that are too hard.
Another cause is when the skin becomes sheared. This is when the skin and the bone go separate ways, and this can occur if someone is slouching, during transfers when sliding instead of lifting, and extended sitting at an angle in bed. Ensuring your position is moved regularly is important.
Continually monitor the skin for bumps, scrapes, cuts or bruises, as these can go unnoticed, and can cause pressure sores or even lead to infections.
Why might I get a pressure sore and how can I prevent them?
Paralysis causes muscles to atrophy, losing much of their mass. Muscles are ideal padding for the more bony areas, such as the bottom, and so without them providing that cushioning, there is much more pressure on the skin.
Cleanliness
Proper attention to the skin is crucial in the prevention of pressure sores. When skin is not cleaned of moisture, such as perspiration or stool, it can become prone to infection and more likely to break down.
Moisture
Similarly, the same can happen if skin becomes too dry. Failure to effectively wash and dry skin can be another cause of pressure sores, and so it is important to ensure you find an appropriate soap that is gentle on your skin. When washing, pay special attention to the folds of the skin where moisture can collect. Drying is just as important, because if the skin is left wet, as mentioned above, it can become sore, infected, and quickly broken down.
Circulation
Decreased circulation is another of the most common causes of pressure sores. As previously discussed, in order for the skin to remain healthy, it requires a good flow of blood. When circulation is decreased, so is that blood flow, and so chances of pressure sores occurring are already heightened.
Smoking
Smoking is to be avoided! Although there are many more reasons to stop smoking, the main reason in regards to pressure sores is that nicotine constricts the blood vessels, slowing blood flow. High blood pressure and diabetes can also affect circulation, so communicating with your doctor about your health is important.
Movement
Lack of movement of paralyzed limbs can also decrease circulation, as sufficient blood flow and nutrients cannot reach all areas effectively. This leads to skin cells dying, and pressure sores developing. Be careful, however, when transferring from one surface to another so as not to bump or shear the skin. Landing too heavily onto a chair or bed can cause bruising and risk the development of pressure sores down the line.
Make Skin Checks Part of Your Routine
Regularly checking skin is a wise habit to get into. With decreased sensation in paralyzed limbs, you need to actively ensure not skin is becoming infected or reddening; a precursor to pressure sores. Pressure sores are more likely to develop in bony areas, which include the lower back and buttocks, as well as the heels, ankles, and toes.
