Pressure ulcers are one of the most serious complications of spinal cord injury. They lead to pain, infection and increased mortality.

Researchers have identified factors which increase the likelihood that an individual with spinal cord injury will be repeatedly hospitalized for pressure ulcers. The most important of these are called modifiable risk factors, which means the environment or behaviors can be changed to reduce the risk of ulcer development. In a recent research study, it was found that power chair use without correctly using the tilt function, and inadequate management of muscle spasticity are important modifiable risk factors which appear to have a direct impact on the need to be hospitalized for a pressure ulcer.

Using the Power Chair Correctly

Medical professionals have found that many spinal cord patients who use power chairs do not correctly use the tilt and recline functions that are supposed to help prevent pressure ulcers. The ischial tuberosities (the bones of the pelvis you feel when you are sitting) put pressure on the tissue and reduce blood flow to the skin. It is suggested that in order to adequately take pressure off sensitive areas, the wheel chair tilt needs to be “at least 35° for enhancing skin perfusion over the ischial tuberosity when combined with recline at 100° and should be at least 25° when combined with recline at 120°.”

Controlling Muscle Spasticity

When the muscles are spastic this increases the friction on certain areas of the skin. This friction has been found to increase the likelihood of skin and tissue irritation which can lead to pressure ulcer development. By taking a proactive role in managing spasticity, and also identifying areas of friction, it is believed that pressure ulcer risk can be reduced.

Getting Adequate Support

Spinal cord injury victims benefit from the assistance of personal caregivers who can help ensure factors such as chair tilt and muscle spasticity are adequately managed. Dr. Greg Vigna is both a rehabilitation physician and personal injury attorney who understands the risks and life-long requirements of injury victims. Please contact our law offices today for a case evaluation so we can help you get the care you need, or determine if negligence resulted in hospitalization for pressure ulcers.

Goodman, B. L., Schindler, A. A., Washington, M. M., Bogie, K. M., & Ho, C. H. (2014). Factors in rehospitalisation for severe pressure ulcer care in spinal cord injury/disorders. Journal Of Wound Care, 23(4), 165-175.

Jan, Y.K., Crane, B.A., Liao, F., et al. Comparison of muscle and skin perfusion over the ischial
tuberosities in response to wheelchair tilt-in-space and recline angles in people with spinal cord injury. Arch Phys Med Rehabil 2013; 94: 10, 1990–1996.