Why are PU so common in SCI?
“The easy answer to ‘Why’ is lack of neurological protective sensation, making the patient unaware that tissue is being harmed” (Rappl, 2008). Recurrence of PU can be blamed on both 1) the weakness of scar tissue and, 2) the lack of protective sensation (Rappl, 2008)
The picture above (click to enlarge) illustrates the normal physiological process of wound healing. Physiological deficits that occur post-SCI impair practically every step of the wound healing process, as depicted below (click to enlarge) (Rappl, 2008)
Bed rest is a standard method to remove pressure to allow tissue to heal. However, research suggest that immobilization further decreases the physiological response of tissues (see Rappl, 2008). In addition, clients with SCI taking anticoagulants (to prevent deep vein thrombosis) have impaired clot formation, which further limits the wound healing process (Rappl, 2008)
Metabolic and physiological deficiencies below the level of the client’s injury explain why PU in SCI clients are so common, difficult to close, and difficult to maintain closed (Rappl, 2008). The literature suggests that “knowledge of these deficiencies may help the clinician to justify change in treatment to influence one of the potential deficiencies” (Rappl, 2008). For more information on the physiologic changes stemming from spinal cord injury, access the full article by clicking here: Rappl, 2008
Metabolic and physiological deficiencies below the level of the client’s injury explain why PU in SCI clients are so common, difficult to close, and difficult to maintain closed (Rappl, 2008). The literature suggests that “knowledge of these deficiencies may help the clinician to justify change in treatment to influence one of the potential deficiencies” (Rappl, 2008). For more information on the physiologic changes stemming from spinal cord injury, access the full article by clicking here: Rappl, 2008