Pressure sores are the most common and devastating medical complication of spinal cord injury. Also referred to as skin sores, decubiti, decubitus ulcers, or bedsores, pressure ulcers are more apt to occur after SCI due to lack of movement and sensation and to changes in circulation. A pressure sore is any redness or break in the skin caused by too much pressure on your skin for too long a period of time. Sitting or lying in the same position will begin to cut off the flow of blood to that area, blocking oxygen and vital nutrients from maintaining healthy tissue. When the tissue becomes starved to too long a period of time it begin to die and a pressure sore starts to form. Normally the nerves send messages of pain or feelings of discomfort to your brain to let you know that you need to change position, but damage to your spinal cord keeps these messages from reaching your brain. A pressure sore is serious. It must NOT be ignored.
What Are The Causes?
Because your blood flows more slowly after SCI, your healing ability is reduced, and your skin cannot tolerate as much pressure as before. The decrease in circulation and lower tolerance for pressure is further aggravated by the lack of sensation after SCI. This lack of sensation means there is no longer a feedback mechanism to tell you that there is a problem – that you have been sitting too long without moving or that you have injured yourself.
The first symptom – your warning signal – is a reddened area of the skin. No damage has occurred if you remove the pressure and the redness fades with 15 minutes after the pressure is removed. Skin damage from pressure usually begins over bony prominences – any place on the body where the bones are close to the skin surface, such as the hip. Due to the decrease in the rate of circulation that occurs following SCI, there is also less oxygen to the skin. This contributes to a lowering of the skin's resistance. If the skin is deprived of oxygen due to pressure, the body will try to compensate by sending more blood to the area. This may result in swelling, which will put even further pressure on the blood vessels and further block circulation.
How a pressure sore develops: