Taking care of your skin

Your skin is the largest organ system in the body and protects the underlying cells against air, water, foreign substances and bacteria. It is sensitive to injury and has remarkable self-repair capabilities. However, prolonged pressure on the skin and the underlying tissue causes it to lose its quality. If the pressure is not relieved the skin can break down, producing a pressure sore.

People living with a spinal cord injury are at high risk of developing skin problems. Limited mobility coupled with impaired sensation can lead to pressure sores or ulcers, which can be a devastating complication. If not treated, pressure sores can ulcerate, leading to a medical emergency and prolonged hospital stay.

Pressure ulcers, also called bedsores, range in severity from mild (minor skin reddening) to severe (deep craters that can infect all the way to muscle and bone). Unrelieved pressure on the skin squeezes tiny blood vessels, which supply the skin with nutrients and oxygen. When skin is starved of blood for too long, tissue dies and a pressure ulcer forms.

Risk of pressure injuries can be reduced by checking your skin daily, using pressure-relieving mattresses and cushions, by shifting weight, or being turned if you cannot move independently.

What can cause a pressure ulcer?

As a result of paralysis, circulation is reduced and less oxygen is available to the skin, lowering the skin’s resistance. The body tries to compensate by sending more blood to the area. This may result in swelling, adding more pressure to the blood vessels.

Sliding around in a bed or chair can cause blood vessels to stretch or bend, leading to pressure ulcers. An abrasion can occur when your skin is pulled across a surface instead of lifted. A bump or fall can cause damage to the skin and not show up right away. Other causes of pressure sores are braces or hard objects that put pressure on your skin. Also, people with limited sensation are prone to skin injuries from burns.

A skin sore begins as a red area on the skin. This reddened area may feel hard and/or hot. For those with darker skin, the area may appear shiny. At this stage, the progression is reversible. The skin will return to its normal colour if the pressure is removed. If the pressure is not removed, a blister or scab may form – this means that the tissue underneath is dying. Remove all pressure over the area immediately.

Treatment

Skin injuries can become more complicated by hard-to-treat infections, spasticity, additional pressure and even the psychological makeup of the person. In fact, pressure sores have been linked to low self-esteem and impulsive behaviour.

It’s an oversimplification to say pressure sores are always preventable but that’s almost true. With vigilant care and good overall hygiene, skin integrity can be maintained.

A wide variety of pressure-relieving support surfaces, including special beds, mattresses, mattress overlays or seat cushions are available to support your body in bed or in a chair. Work with your therapists to know what is available.

Prevention tips

You are responsible for your own skin care. Here are few tips to maintain healthy skin:

  • Check your skin daily: use a mirror for hard-to-see areas. Skin stays healthy with good diet, good hygiene and regular pressure relief.
  • Keep the skin clean and dry: skin that is moist from sweat or bodily discharges is more likely to break down.
  • Drink plenty of fluids: a healing wound or sore can lose more than a quart of water each day. Drinking 8 to 12 cups of water a day might not be too much. Beer and wine do not count; alcohol actually causes you to lose water or become dehydrated.
  • Watch your weight: being too thin causes you to lose the padding between your bones and your skin and makes it possible for even small amounts of pressure to break down the skin. Getting too heavy is risky, too. More weight may mean more padding, but it also means more pressure on skin folds.
  • Don’t smoke: research has shown that heavy smokers are more prone to skin sores.
How can SCIA help?

When you become a member with us, you can take advantage of these discounts from many of our partners:

  • Revitalife can help you choose the right adjustable bed or reclining chair for your needs. Your SCIA membership will give you 30% off all products.
  • Independent Living Specialists (ILS) are Australia’s largest provider of mobility scooters and lift chairs. Your SCIA membership will give you 10% off all products except power chairs.
  • Permobil manufacture wheelchairs, seating and positioning as well as communication systems. Every purchase with your SCIA membership will come with a free gift.

SCIA is a registered National Disability Insurance Scheme (NDIS) provider. Although, we don’t directly provide assistive technology equipment or assessments, we have many professional contacts who specialise in assessing and recommending equipment for people with SCI and other physical disability and can assist you to achieve your goals in this area through advice and support under Support categories 7 (Coordination of supports) and 14 (Improved life choices).

This can include sourcing the appropriate professional for you, organising assessments and paying all expenses as your plan manager.

Further reading and information

There is a wealth of information about understanding pressure injuries and the various treatment options available. Visit the SCIA Resources Library – skin management, to read articles, publications and more.

For further information on this or any other topic please call SCIA by phone on 1800 819 775 or email info@scia.org.au.

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