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When You Develop a Pressure Ulcer/Injury

A spinal cord injury or disease puts you at risk for developing pressure ulcers/injuries. A plan of regular weight shifting, frequent inspections, and good general health practices can help prevent most pressure ulcers/injuries. But pressure ulcers/injuries may not always be preventable. Even with the best plan and self-care, an ulcer/injury may still form. If this happens to you, don’t despair. Ulcers/injuries are treatable. And good self-care will help you catch them early, when they are easiest to treat.

Pressure ulcer/injury warning signs

Check your skin twice a day, in the morning and evening. To see places you can’t reach, use a mirror or have someone inspect for you. If you notice any changes or problems, call your healthcare provider right away. Look for the following:

  • Skin redness that doesn’t go away or (fade) in a few minutes

  • New red, purple, bruised or darkly pigmented/discolored skin areas (over bony areas such as heels, hips, etc.)

  • Soft, warm, or cool spots

  • Swelling or hard areas

  • Scrapes, cuts, blisters, boils, or pimples

  • Any new openings in the skin

  • An area of the skin that hurts or has a change in sensation (this may not happen if your sensation is impaired)

Ulcers/injuries can begin deep below the surface of the skin. So an open wound is not necessary for a pressure ulcer/injury to be present. This is why it is important that you pay attention to all changes in skin appearance and what you can feel with your fingers.

Note: Pressure ulcers/injuries may be difficult to detect in darkly pigmented or darker skin tones. Changes in skin color or redness may not be easily recognized and differ from surrounding skin areas.

Treatment for pressure ulcers/injuries

Treatment will vary depending on your health, the size and severity of the ulcer/injury, and other factors. Treatment will include:

  • Relieving all pressure on the area until the pressure ulcer/injury heals or is surgically closed

  • Special wound dressings (don’t use anything that isn’t prescribed)

Depending on your wound and situation, treatment might also include:

  • Methods to remove dead tissue from the wound so it can heal

  • Antibiotics to clear up an infection

  • Medical procedures or surgery to close the wound

Your healthcare provider will work with you to plan the best treatments. Be sure you understand your options. If you wish, family members or others who help you with your care should be included in the discussion.

Checking your pressure ulcer/injury

When you have a pressure ulcer/injury, you should look at it to make sure there are no problems.  Look at the ulcer/injury during each dressing change. Use a mirror to see all parts of the ulcer/injury. If you can’t see the ulcer/injury, have someone who helps with your care inspect it. Look for problems such as:

  • Fluid soaking all the way through the dressing

  • Further changes in skin color, such as redness, darker color of the skin or warmth around the pressure ulcer/injury

  • Pus

  • New areas of black, discolored, or dead tissue

  • The skin around the ulcer/injury gets too wet and becomes white

  • A bad smell

  • Fever

  • Loss of appetite

  • Pain (if you have sensation around the ulcer/injury)

If you notice any of these or any other problems, let your spinal cord injury or disorder (SCI/D) team know right away. NOTE: Depending on the level of your injury, you may get autonomic dysreflexia (AD) from a pressure ulcer/injury. Discuss AD management with your SCI/D team.

Pressure ulcer/injury prevention

Having a pressure ulcer/injury complicates positioning in bed and in your wheelchair. You should try to stay away from putting any direct pressure on the ulcer/injury. This puts other areas that you lie and sit on at increased risk for the development of pressure ulcers/injuries. Discuss this with your SCI/D team. Make sure you do additional pressure releases to avoid new skin breakdown and ulcers/injuries.

Having an SCI/D means having a lifelong risk for developing pressure ulcers/injuries. So take steps every day to prevent the ulcers/injuries and check your skin for warning signs. Go back to your SCI Center every year for a wellness health check. Whenever you have questions or need assistance, call your SCI/D coordinator or local SCI/D team. If you develop signs of a pressure ulcer/injury, tell your healthcare provider right away. You may not be able to prevent every pressure ulcer/injury. But you can prevent them from keeping you from living your life to the fullest.

To learn more

For more information, go to the Pressure Ulcer/Injury Resource mobile app.

Author: StayWell Custom Communications
Last Annual Review Date: 8/1/2018
Copyright © The StayWell Company, LLC. except where otherwise noted.
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