Pressure sores are a frequent and
serious complication of a
spinal cord injury (SCI). They are an injury to the
skin and underlying tissue usually caused by unrelieved pressure. A pressure
sore can lead to serious complications, such as infection of the bone (osteomyelitis) or blood (sepsis).
To help prevent pressure sores:
Inspect your skin at least twice a day,
bony prominences such as along the spine, at the lowest part of the back
(sacrum), around the hips, elbows, and knees, and the
back of the head. Try to check whenever you change position. You may need a
long-handled mirror or have to ask someone for help. Watch for:
Any area of skin where you previously had a
pressure sore or other sore; scar tissue breaks down
Redness, blisters, open sores, or rashes. If possible, use
the back of your fingers to feel for heat in red areas.
Keep your skin clean (free of sweat, wound
drainage, urine, and feces). Use a mild cleansing soap to keep skin healthy,
but be careful not to scrub the skin too hard.
Keep your skin
moisturized. Limit exposure to dry, cold weather. And use lotion to keep skin
moisturized. Dry skin can become weak and vulnerable to pressure
Eat a healthy diet with enough protein to keep skin healthy
and resistant to pressure sores and able to heal more
Relieve pressure in bed. You will need
pressure-relieving devices and supports and a turning
schedule. You will need to turn every 2 to 5 hours, depending on body type.
This includes at night. You can lie for up to 8 hours on your stomach with the
Relieve pressure when you are in your wheelchair.
Shifting your weight is most effective. You and your therapists will find the
best way to do this. You can also use cushions, which provide pressure relief
and weight distribution. Work with your therapists to figure the best cushion
for you. Also:
Make sure the foot pedals of your wheelchair
are adjusted to the right height for you. Having your foot pedals too high will
put pressure on your hips. And having them too low can put pressure on the
backs of your legs.
Sit up straight in your wheelchair. Slumping or
slouching leads to added pressure over the end of your
Try to lean to one side now and then to help relieve
Do a weight shift every 20 minutes.
your wheelchair cushions regularly for leaks, tears, or "flattened" gel (gel
Watch your clothing and accessories. Be sure your
shoes are not too loose or too tight. Avoid tight clothing, clothing with heavy
seams, and nylon underwear.
Avoid smoking. Smoking dries out the
skin and reduces blood supply to the skin, which can help pressure sores form
and also slow the healing process.
Primary Medical Reviewer
Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer
Nancy Greenwald, MD - Physical Medicine and Rehabilitation
How this information was developed to help you make better health decisions.