Pressure sores are one of the worst potential complications of a
spinal cord injury. However with appropriate skin
management techniques you can prevent
In order to prevent skin sores,
whole body frequently
care of your skin
Check your whole body, but
pay special attention to bony areas:
By inspecting your skin regularly, you can spot a problem at the
very beginning. Checking your skin is your responsibility and
the way to spot the warning signals of a problem. Don't just ask
someone else how your skin looks. If you need someone to help
you check, you must be able to tell him or her what to look for.
least twice daily. Morning and evening when dressing or
undressing are recommended.
Check more frequently if you
are increasing sitting or lying times.
Checking whenever you change
position is recommended
Any areas previously broken and
healed over - scar tissue breaks easily.
What Are You Looking For?
Redness, blisters, opening in
skin, rashes, etc. Feel for heat in red areas with the
back of your fingers.
Long-handled mirrors. If you
need help, ask someone to position mirrors for you - one
at the head and one over the pressure point.
Which Parts To Check?
the areas shown in the diagram below on the front, back,
and sides of your body.
Remember: Bony areas of the body are the
most likely to get sores, so be sure and look at them.
When checking you skin, don't forget your
groin areas for rashes or sores from tight clothing.
Men who wear an external catheter should
check the penis carefully for sores or irritations.
Skin Pressure: In
addition to routinely checking your skin, a second important way
to prevent pressure sores is to relieve skin pressure by
changing position or being positioned so that pressure is taken
off a bony area. The purpose of relieving pressure is to let the
blood supply get to the skin. If pressure is not relieved, blood
will continue to be pressed out of a blood vessel and will not
get to the skin to keep it healthy
Pressure Relief in a
Weight shifts are the most essential techniques for preventing
pressure on the skin and muscle of the sacrum (tailbone) and
each hip. Use the method you and your therapists have found to
be the most effective for you. Know your skin tolerance at all
times. The frequency with which you do weight shifts vary from
time to time.
cushion for your wheelchair is essential. Cushions provide
pressure relief and weight distribution and thus aid in the
prevention of pressure sores. Many types of cushions exist, but
there is no "ideal" cushion. Use the cushion recommended by your
If air is used in the cushion,
check to see that it is filled correctly. If you are going to
a different altitude, there will be a change in your cushion.
If your cushion is made of foam,
check to see that it is firm and in good condition. If it gets
dry, powdery and loses its firmness, replace it immediately.
Use only good quality foam. Polyurethane foam with a density
of 1.2 and compression of 30 to 35 is recommended.
In case of body weight change,
you may need to change the width of your chair, the frequency
of your weight shifts, and the type of cushion you use.
rubber air rings or rubber doughnuts. They are dangerous because
they block the flow of blood to the skin inside the leg. Weight
shifts are essential. The cushion alone will not prevent
sure the foot pedals of your wheelchair are adjusted to the
right height for you. If your foot pedals are too high, it
will put pressure on your hips;
Sit up straight in your chair.
Slumping or slouching leads to added pressure over the end of
Lifting your bottom from the
wheelchair may be managed by lifting through your arms and
taking your body weight for at least 30 seconds. If you
don't have sufficient strength to do this yourself assisted
relief can be practiced by leaning forwards or to one side.
Stages of Pressure Sores