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Rehabilitation Institute of Chicago: LIFE Center

Skin Care after Spinal Cord Injury

Reviewed August 2012
Author: Rehabilitation Institute of Chicago - Nursing Practice Council

Individuals with spinal cord injuries may be at risk for skin problems because of changes in sensation and movement. Skin problems, such as pressure ulcers (also known as pressure sores), can occur when a person lies or sits in one position for a long period of time and is not able to move without help. Also, the inability to feel when something is sharp or hot can lead to cuts or burns.

The skin continues to function as it did before the injury. The biggest change is that persons with spinal cord injuries may not be able to protect their skin from injury in the same way. Before the injury, the ability to sense pain from being in one position for a long time was normal. After the injury, remaining in one position for a long time can cause a problem with blood flow to the skin. If the blood supply is cut off because of not changing position, the skin can begin to break down, causing pain. As it begins to hurt, a person with normal sensation will shift position. This is still true following a SCI except the person with the injury will not feel the pain and change their position, allowing the blood to flow again. This can result in the development of sores.

Being aware of these changes can help prevent skin problems. Follow the guidelines below.

Normal Function of the Skin

The skin is an important part of the body that works in many ways to maintain health:

  • Protects people from outside injury or illness
  • Prevents germs from entering the body
  • Keeps fluids and nutrients inside the body
  • Helps to control body temperature in hot and cold weather

Skin has several layers of tissue that covers the body. Some tissues are filled with tiny blood vessels that move oxygen and nutrients to the skin. The skin also has nerves, which send messages from different parts of the body to the brain. These make an individual aware of touch, pain and temperature. Other nerves give information about where body and body parts (arms, legs) are positioned in space and whether they are lying on an object.

Keeping Skin Healthy

Healthy skin is intact, well lubricated with natural oils and nourished by a good blood supply. Skin stays healthy with a balanced diet, good hygiene, regular skin checks and pressure relief. Relieving pressure and checking skin will ensure a good blood supply and improve the health of your skin.

Hygiene

  • Keep skin clean and dry. Skin that is wet from urine, sweat or stool is more likely to break down.
  • Dry skin well after bathing, but do not rub hard with a towel as this can hurt the skin.
  • Do not bathe everyday unless really needed. Daily baths wash away natural oils that lubricate the skin.
  • Do not use skin drying alcohol massages over bony areas of the body. If a back rub helps you relax, ask that massage be done with a gentle lotion.

Nutrition

  • Eat a healthy diet. Protein, vitamins and iron are especially important. Consult with a nutrition professional to plan a diet that to meet your needs.
  • Drink six to eight glasses of fluid every day.
  • Pureeing or chopping foods does not change their nutritional value. Tube feedings are chosen to provide all necessary nutrients.
Checking Bony Areas for Pressure Sores

Skin inspection

  • Check the skin to spot sores when they are just starting.
  • Don't depend on others to tell you how your skin looks. If you need help, however, clearly tell others what warning signs they should try to look for.
  • Check the entire body, especially bony areas, at least twice a day - morning and evening, when you change position. Check more often if increasing sitting or turning times.
  • checking for pressure sores
  • Use a long handled mirror to see all areas.
  • Be alert to areas that have been broken and healed. Scar tissue breaks very easily.
  • Look for red areas, blisters, openings in the skin or rashes. In red areas, use the back of your strong hand to feel for heat.
  • Check the groin area. Men who wear an external catheter should check penis for sores or other problems.

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