Pressure Ulcers in Neurologically Compromised Patients
People suffering from neurological disabilities are at high risk of developing pressure ulcers. Prolonged seating and pressure, shearing forces and stress are the main causes for microcirculatory occlusion that results in ischemia. Due to theincreased demand for oxygen, irreversible changes in muscles may occur after as little as 2 h of uninterrupted pressure. The skin in comparison can withstand direct pressures of up to 12 h. Therefore when it breaks down, the skin reveals already established soft tissue damage. The regular lifting that patients with spinal cord injury have been taught may be too brief to protect against pressure ulcers. Other factors come into play, like lack of sensation, spasticity, chronic contractures, disuse atrophy, and poor general condition. Pressure ulcers are predominant in the sacral area, and heels. When they occur, they are monitored according to the European Pressure Ulcer Advisory Panel grading system. Preventative measures take into account the above facts, whereas treatment options are conservative (non-surgical) methods and surgery. Post-healing measures include a gradual and time monitored mobilisation protocol of the patient with an appropriate cushion.
KeywordsNeurological disability Neurological compromise Neurologically impaired Stroke Spinal cord injury Multiple sclerosis Motor neurone disease Brain injury Pressure ulcer Flap surgery
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