Skip to main content
SpringerLink
Log in

Preventing and Managing Pressure Injuries in Spinal Cord Injuries

  • Chapter
  • First Online:
A Practical Guide to Care of Spinal Cord Injuries

  • 361 Accesses

Abstract

This chapter focuses on the issue of pressure injuries in patients with spinal cord injuries. It also highlights the prevalence, potential complications, and impact on the quality of life of individuals with spinal cord injuries who experience pressure injuries. Pressure injuries are a common and preventable complication that affects up to 80% of spinal cord injury patients during their lifetime, with up to 30% experiencing recurrent issues. The risks associated with pressure injuries are significant and can include infections, osteomyelitis, sepsis, and death. Additionally, pressure injuries can lead to rehospitalization and decreased community integration. The chapter discusses the evolution of terminology in this field, with the term “pressure injury” now preferred over “pressure ulcer.” The updated definitions and stages provided by the National Pressure Injury Advisory Panel (NPIAP) are also addressed in the chapter. The goal of the chapter is to provide clinicians with the necessary knowledge and tools to prevent and manage pressure injuries in patients with spinal cord injuries. Prevention strategies, including proper positioning and turning, pressure redistribution, and skin care, are discussed in detail. The chapter also covers the various treatment options available for pressure injuries, including wound dressings, debridement, and surgical interventions. By implementing effective prevention and management strategies, the incidence and severity of pressure injuries can be reduced, leading to improved patient outcomes and decreased financial burden on healthcare systems.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ayello EA, Belmore B, Smart H, et al. Survey results from The Philippines: NPUAP changes in pressure injury terminology and definitions. Adv Skin Wound Care. 2018;31:601–6.

    Article  PubMed  Google Scholar 

  • Barnett RI, Ablarde JA. Skin vascular reaction to short durations of normal seating. Arch Phys Med Rehabil. 1995;76:533–40.

    Article  CAS  PubMed  Google Scholar 

  • Bass MJ, Phillips LG. Pressure sores. Curr Probl Surg. 2007;44:101–43.

    Article  PubMed  Google Scholar 

  • Berkwits L, Yarkony GM, Lewis V. Marjolin’s ulcer complicating a pressure ulcer: case report and literature review. Arch Phys Med Rehabil. 1986;67:831–3.

    CAS  PubMed  Google Scholar 

  • Boyko TV, Longaker MT, Yang GP. Review of the current management of pressure ulcers. Adv Wound Care (New Rochelle). 2018;7:57–67.

    Article  PubMed  Google Scholar 

  • Byrne DW, Salzberg CA. Major risk factors for pressure ulcers in the spinal cord disabled: a literature review. Spinal Cord. 1996;34:255–63.

    Article  CAS  PubMed  Google Scholar 

  • Caliri MHL. Spinal cord injury and pressure ulcers. Nurs Clin North Am. 2005;40:337–47.

    Article  PubMed  Google Scholar 

  • Chen Y, Devivo MJ, Jackson AB. Pressure ulcer prevalence in people with spinal cord injury: age-period-duration effects. Arch Phys Med Rehabil. 2005;86:1208–13.

    Article  PubMed  Google Scholar 

  • Consortium of Spinal Cord Medicine. Pressure ulcer prevention and treatment following spinal cord injury. A clinical practice guideline for health care professionals. 2nd ed. Washington, DC: Paralyzed Veterans of America; 2014.

    Google Scholar 

  • Daniel RK, Wheatley D, Priest D. Pressure sores and paraplegia: an experimental model. Ann Plast Surg. 1985;15:41–9.

    Article  CAS  PubMed  Google Scholar 

  • Dhall SS, Hadley MN, Aarabi B, et al. Nutritional support after spinal cord injury. Neurosurgery. 2013;72:255–9.

    Article  PubMed  Google Scholar 

  • Dinsdale SM. Decubitus ulcers: role of pressure and friction in causation. Arch Phys Med Rehabil. 1974;55:147–52.

    CAS  PubMed  Google Scholar 

  • Dorsett P, Geraghty T. Health-related outcomes of people with spinal cord injury: a 10 year longitudinal study. Spinal Cord. 2008;46:386–91.

    Article  CAS  PubMed  Google Scholar 

  • Dumurgier C, Pujol G, Chevalley J, et al. Pressure sore carcinoma: a late but fulminant complication of pressure sores in spinal cord injury patient: case reports. Paraplegia. 1991;29:390–5.

    CAS  PubMed  Google Scholar 

  • Edsberg LE, Black JM, Goldberg M, et al. Revised national pressure ulcer advisory panel pressure injury staging system: revised pressure injury staging system. J Wound Ostomy Continence Nurs. 2016;43:585–97.

    Article  PubMed  PubMed Central  Google Scholar 

  • Frisbie JH. Wound healing in acute spinal cord injury: effect of anticoagulation. Arch Phys Med Rehabil. 1986;67:311–31.

    CAS  PubMed  Google Scholar 

  • Groah SL, Schladen M, Pineda CG, et al. Prevention of pressure ulcers among people with spinal cord injury: a systematic review. PM R. 2015;7:613–36.

    Article  PubMed  Google Scholar 

  • Ho CH, Bogie K. The prevention and treatment of pressure ulcers. Phys Med Rehabil Clin N Am. 2007;18:235–53.

    Article  PubMed  Google Scholar 

  • Huang L, Woo KY, Liu LB, et al. Dressings for preventing pressure ulcers: a meta-analysis. Adv Skin Wound Care. 2015;28:267–73.

    Article  PubMed  Google Scholar 

  • International Review. Pressure ulcer prevention: pressure, shear, friction and microclimate in context. A consensus document. London: Wounds International; 2010.

    Google Scholar 

  • Jones KR, Fennie K, Lenihan A. Evidence-based management of chronic wounds. Adv Skin Wound Care. 2007;20:591–600.

    Article  PubMed  Google Scholar 

  • Kosiak M. Etiology of decubitus ulcers. Arch Phys Med Rehabil. 1961;42:19–29.

    CAS  PubMed  Google Scholar 

  • Kruger EA, Ires M, Ngann Y, et al. Comprehensive management of pressure ulcers in spinal cord injury: current concepts and future trends. J Spinal Cord Med. 2013;36:572–85.

    Article  PubMed  PubMed Central  Google Scholar 

  • Makhsous M, Priebe M, Bankard J, et al. Measuring tissue perfusion during pressure relief maneuvers: insights into preventing pressure ulcers. J Spinal Cord Med. 2007;30:97–507.

    Article  Google Scholar 

  • Mandt J, Teasley-Strausburg K, Shronts E. Nutritional requirements. In: Teasley-Strausburg K, editor. Nutritional support handbook. Cincinnati: Harvey Whitney Books; 1992.

    Google Scholar 

  • Meijer JH, Germs PH, Schneider H, et al. Susceptibility to decubitus ulcer formation. Arch Phys Med Rehabil. 1994;75:318–23.

    Article  CAS  PubMed  Google Scholar 

  • Michael K. Prevention and rehabilitation of pressure ulcers. Adv Skin Wound Care. 1991;4:60–9.

    Google Scholar 

  • National Pressure Ulcer Advisory Panel. Pressure ulcer stage revised by NPUAP. Washington, DC: NPUAP; 2016. http://www.npuap.org/resources/educational-and-clinical-resources/pressure-injury-staging-illustrations/, http://www.npuap.org/resources/educational-and-clinical-resources/npuap-pressure-injury-stages/.

    Google Scholar 

  • National Pressure Ulcer Advisory Panel (NPUAP). Pressure ulcer scale for healing, PUSH tool version 3.0. 1998. http://www.npuap.org/resources/educational-and-clinical-resources/push-tool/push-tool/.

  • National Spinal Cord Injury Statistical Center (NSCISC). The 2020 annual statistical report for the spinal cord model systems. Birmingham, AL: National Spinal Cord Injury Statistical Center; 2021.

    Google Scholar 

  • Nola GT, Vistnes LM. Differential response of skin and muscle in the experimental production of pressure sores. Plast Reconstr Surg. 1980;66:728–33.

    Article  CAS  PubMed  Google Scholar 

  • Patterson RP, Fisher SV. Sitting pressure-time patterns in patients with quadriplegia. Arch Phys Med Rehabil. 1986;67:812–4.

    CAS  PubMed  Google Scholar 

  • Posthauer ME, Banks M, Dorner B, et al. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper. Adv Skin Wound Care. 2015;28:175–88.

    Article  PubMed  Google Scholar 

  • Reddy M, Gill SS, Kalkar SR, et al. Treatment of pressure ulcers: a systematic review. JAMA. 2008;300:2647–62.

    Article  CAS  PubMed  Google Scholar 

  • Regan MA, Teasell RW, Wolfe DL, et al. A systematic review of therapeutic interventions for pressure ulcers after spinal cord injury. Arch Phys Med Rehabil. 2009;90:213–31.

    Article  PubMed  PubMed Central  Google Scholar 

  • Reger SI, Ranganathan VK, Sahgal V. Support surface interface pressure, microenvironment, and the prevalence of pressure ulcers: an analysis of the literature. Ostomy Wound Manage. 2007;53:50–8.

    PubMed  Google Scholar 

  • Registered Nurses’ Association of Ontario (RNAO). Assessment and management of pressure injuries for the interprofessional team. 3rd ed. Toronto, ON: Registered Nurses’ Association of Ontario; 2016.

    Google Scholar 

  • Rosin NR, Tabibi RS, Trimbath JD, et al. A primary care provider’s guide to prevention and management of pressure injury and skin breakdown in people with spinal cord injury. Top Spinal Cord Inj Rehabil. 2020;26:177–85.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shai A, Maibach HI. Wound healing and ulcers of the skin. Diagnosis and therapy-the practical approach. New York: Springer; 2005.

    Google Scholar 

  • Sunn G. Spinal cord injury pressure ulcer treatment: an experience-based approach. Phys Med Rehabil Clin N Am. 2014;25:671–80.

    Article  PubMed  Google Scholar 

  • The Editors of Nursing. Pressure ulcers get new terminology and staging definitions. Nursing. 2017;47:68–9.

    Article  Google Scholar 

  • Weidner N, Rupp R, Taney KE, editors. Neurological aspects of spinal cord injury. Cham: Springer; 2017.

    Google Scholar 

  • Yarkony GM. Pressure ulcers: a review. Arch Phys Med Rehabil. 1994;75:908–17.

    Article  CAS  PubMed  Google Scholar 

  • Young RR, Woolsey RM, editors. Diagnosis and management of disorders of the spinal cord. Philadelphia, PA: W.B. Saunders; 1995.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Parkside Rehabilitation Hospital, Busan, Korea (Republic of)

    Hyun-Yoon Ko

  2. Department of Rehabilitation Medicine, Pusan National University College of Medicine, Yangsan, Korea (Republic of)

    Hyun-Yoon Ko

Authors
  1. Hyun-Yoon Ko
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ko, HY. (2023). Preventing and Managing Pressure Injuries in Spinal Cord Injuries. In: A Practical Guide to Care of Spinal Cord Injuries. Springer, Singapore. https://doi.org/10.1007/978-981-99-4542-9_30

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-4542-9_30

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-4541-2

  • Online ISBN: 978-981-99-4542-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation