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SKIN MANAGEMENT IN SPINAL CORD INJURY: SKIN SORES: PROGRESSION OF SKIN SORES

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     A skin sore begins as a red area on the skin. This reddened area may or may not feel hard and/or hot. If you have black skin, the area may appear shiny instead of red. At this stage, the progression is reversible. You must remove all pressure from this area until the skin returns to its normal color.

     If pressure is not removed, a blister, pimple or scab may quickly form over the hard red area of the skin. This hard red area of skin means that the tissue underneath is dying. At this point, remove all pressure over the area and consult your physician.

     In the next stage, a hole or ulcer forms in the dead tissue. Frequently, this dead tissue is small on the skin surface, but large in the deeper tissues. This damaged tissue may extend all the way to the bone.

     And finally, there is infection and destruction of the underlying bone.


HOW A PRESSURE SORE DEVELOPS

Pressure sores are always caused by pressure.

STAGE AND SIGNS

WHAT TO DO

OTHER INFORMATION

1. Skin becomes white or lighter in color Do push-ups and keep to your turning schedule so skin is never deprived of its blood supply for a long time A. Blood is not getting to the skin because of pressure

B. This change in skin is seen for a moment when pressure is relieved

C. To see what this stage is like, hold a glass tightly; notice your fingertips getting lighter from pressure

2. Skin reddens, is warm and may be swollen when pressure is relieved A. Stay off red area until all redness is gone

B. Do NOT rub red area or put anything on it

C. If you are dark skinned and can't see redness, feel for warmth with back of fingers

A. At this point, you can still stop a sore from developing

B. Redness and warmth caused by blood rushing to the area when pressure is relieved

C. If redness is not gone 30 minutes after pressure is relieved, it's a danger signal (too much pressure or pressure for too long was applied)

3. A blister develops over red area. Skin may have a bluish color to it. The blister often opens A. Stay off the area

B. Call your doctor or nurse

A. This stage occurs if pressure is not completely removed from a red area

B. At this point the damage is deeper than you can see

4. Center of open sore turns black or brown and/or there is drainage A. Stay off area

B. Cover with a sterile dressing

C. Call your doctor

D. Eat foods that are high in protein

A. This sore may be very deep and is probably infected. You may feel very sick.

B. If there is much drainage your body loses protein. Protein is needed for healing.

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