Sarah Arnold, Associate in the Higgs LLP Personal Injury team, offers tips on skin care after a spinal cord injury.
The impacts of a spinal cord injury (SCI) can be far-reaching. Along with the obvious adjustments relating to mobility there are also a wide range of other potential complications, including issues with skin care.
At Higgs LLP, we’re passionate about helping clients post spinal cord injury. In addition to assisting with a legal claim following negligence, we also signpost clients to organisations which can help them manage day-to-day life.
The skin is your body’s largest organ and its function is to protect your body. Your skin plays a role in:
- Sensation
- Temperature regulation
- Fluid regulation
- Protection from illness and germs
When you sustain injury to your spinal cord, this results in a loss of function as the damage to the nerves within the spinal canal affects the spinal cord's ability to send and receive messages to coordinate the body's movement and sensation.
A SCI can affect your skin in many ways. For example, you may sweat more or less in different areas and you may encounter swelling as you have no voluntary muscle action below the level of injury.
There are certain factors which can affect your skin such as:
- Hot and cold extremes: Can cause damage to the skin. However, you may not notice until the damage is done because of the loss of skin sensation.
- Moisture: Moist skin is more prone to breakdowns.
- Edema / swelling: When tissues are too swollen, it's hard to get oxygen and nutrients to the skin cells, therefore increasing the chances of having the skin break down.
- Friction: When you drag a part of your body across a surface there may be a constant rubbing or pulling on the skin which can cause blisters.
- Shearing: When two layers of skin are pulled in opposite directions, often when you slide down, either in a wheelchair or in a bed. This can lead to skin breakdown and tears and increases your risk of getting pressure sores. Lifting your body rather than dragging it across surfaces helps to reduce this.
- Pressure ulcers/pressure sores: these develop when you sit or lie in the same position for long periods of time.
- Cuts or burns, due to the decrease in ability to feel something sharp or hot.
- Cuts and bruising may occur as a result of bumping objects due to impulsive or quick movements.
- Skin irritation/rashes are often related to restlessness and constant rubbing of a body part against an object (such as rug burn).
- Skin breakdown due to bladder and/or bowel accidents causing irritation.
- Calluses - accumulations of dead, dry skin. Skin can collect from not being sloughed off by your shoes without walking, your hands from overuse, or from a splint or brace rubbing your skin. The callus becomes dry and cracks over time which allows bacteria to enter
- Generalised unhealthy skin care practices due to cognition deficits and forgetfulness to perform daily care activities. Examples include insufficient bathing and washing.
Inadequate skin management can quickly lead to complications. Post spinal cord injury care is not only important in maintaining healthy looking skin, it also helps to keep your insides healthy and functioning properly.
Maintaining your skin after spinal cord injury:
- Keep your skin healthy, clean and dry; well lubricated and nourished with a good blood supply. After bathing, dry the skin well without rubbing too hard, as it may increase irritation.
- Appropriate bathing: too much bathing washes away natural oils that lubricate the skin. Use a gentle lotion on a regular basis. Keeping your hands clean helps reduce the spread of infection to your body. Keeping your body clean prevents bacteria and viruses from building on the surface of the skin as well as reducing the possibility of germs from entering your body.
- Reduce calluses (accumulations of dead, dry skin) by soaking the area with water, then buffing the area with a towel.
- Inspecting the skin - daily skin inspection will provide early detection and minimize the effects of any skin tissue damage. Inspect the whole body, focusing on the bony areas which are more susceptible to break down. Look for redness, blisters, rashes and any openings in the skin.
- Avoid bumping into things when you are moving around. Be aware of how close you are to possible hazards. Do not sit too close to fires or heaters
- Ensure you have the relevant training before carrying out new manoeuvres in your wheelchair.
- Do not sleep in the wheelchair.
- Nutrition: What you eat affects your skin. Vitamins A, C, E, and B6 are necessary for skin development and maintenance. It is therefore essential to eat a healthy and balanced diet. Drink plenty of water. Keeping hydrated is essential for healthy skin.
- Relieving pressure - When lying down, avoid any pressure bony areas of skin, including heels, knees and hips. Use pillows to help relieve pressure. When sitting in a wheelchair, lean from one side to the other every 30 minutes to relieve pressure. Keep alternating the pressure. Set alarms / reminders for pressure release.
- Weight: Keeping at an appropriate weight can help lower the risk for skin breakdown. Being too thin can increase the risk of pressure injury as your muscles might not be meaty enough to disperse pressure from within the body. On the other hand, having too much weight can put pressure on body fat which compacts and does not disburse pressure.
- Exercise – move the parts of your body below the level of spinal cord injury in addition to body parts above the spinal cord injury. Try a range of motion exercise to stimulate blood flow which helps feed the skin, creates pressure release and improves overall body functions.
It is crucial to understand why your skin is more at risk following a spinal cord injury and to therefore implement a skin care plan.
If you or your loved ones have been unfortunate to suffer a spinal cord injury as a result of an accident then our specialist team at Higgs can assist you in bringing a compensation claim and secure the best rehabilitation and care needed.
