There are numerous other health issues that people with various types of disabilities have to cope with on an almost daily basis. Depending on the “main” disability, other issues such as high blood pressure, urinary tract infections, lack of coordination and the like can compound living with that disability to a more uncomfortable life.
Preventing pressure sores is a daily concern for individuals who have a spinal cord injury. If you are a person dealing with an SCI, you should always work to stay healthy and avoid this serious skin problem in order to be free to do what you would like to do or anything else that life has to offer.
I’d like to discuss this week and next week, too, some of the things you will need to do to prevent pressure sores and how to care for them. At the end of the second article next week, I’ll also list some excellent resources for information you’ll need about the prevention and care of pressure sores.
Pressure sores are known by many names, such as pressure ulcers, decubitus ulcers, ischemic ulcers, bed sores or skin sores. No matter what they are called, they are a serious problem that can take days, weeks, months or even longer to heal.
A pressure sore is an area of the skin or underlying tissue that is dead or dying as a result of the loss of blood flow to the area. It can begin in a number of ways. The most common way is when you or rest on a bony area for a prolonged period of time.
Anyone can get a pressure sore, but individuals with spinal cord injuries are at a much higher risk. It is estimated that up to 80 percent of individuals with an SCI will have a pressure sore during their lifetime, and 30 percent will have more than one pressure sore.
There are a number of factors that can put you at risk, especially if you are disabled by an SCI. They can include disability-induced limited mobility, which can place extended pressure on an area of the body; moisture from bladder and bowel accidents that can further weaken the skin and cause the skin to break down more quickly; a lack of feeling in specific parts of the body that can keep you from sensing that your skin has been damaged; and/or a cut or a scratch that can quickly develop into a larger problem if not properly treated. Spasticity or transfers can also sheer (or rub) the skin and cause damage as well.
The most common sign that a pressure sore is beginning is the appearance of a red area on the skin. Ordinarily, redness should clear within 30 minutes after the pressure is released. If the redness does not clear, a pressure sore has begun. A person with dark skin may also see a change in their skin color. The area may become light, dry, flaky or ashy. Other signs that may indicate the beginning of a pressure sore is an area of skin that is warmer than normal or a change in the skin’s texture.
There are four different stages of a pressure sore. They are:
- Stage 1 — Damage is limited to the top two layers of skin, the epidermal and dermal layers. The skin is not broken and the redness does not turn white when touched.
- Stage 2 — Damage extends beyond the top two layers of the skin to the adipose tissue. The skin is slightly broken. The sore appears to be an abrasion, blister or small crater.
- Stage 3 — Damage extends through all the superficial layers of the skin, adipose tissue, down to and including the muscle. The ulcer appears as a deep crater, and damage to adjacent tissue may be present.
- Stage 4 — Damage includes destruction of all soft tissue structures and involves bone or joint structures. Undermining of adjacent tissue and sinus tracts may be associated with these ulcers.
If you are a person with a spinal cord injury or at risk for a pressure ulcer, I hope that I’ve gotten your attention thus far. You needn’t be overly depressed, though. In addition to those areas we’ve already noted, there are any number of other ways to prevent pressure sores, too.
We’ll complete this series next week with a review of what those other areas are.
Read next article: Basic care can prevent pressure sores