Pressure sore carcinoma: a late but fulminant complication of pressure sores in spinal cord injury patients: case reports

Pressure sores or pressure injury is a serious complication of a spinal cord injury (SCI), representing a challenging problem for patients, their caregivers, and their physicians. Persons with SCI are vulnerable to pressure sores throughout their life. Pressure sores can potentially interfere with the physical, psychosocial, and overall quality of life. Outcomes directly depend on education and prevention along with conservative and surgical management. Therefore, it is very important to understand everything about pressure sores following SCI. This review covers epidemiology, cost, pathophysiology, risk factors, staging, evaluation tools, prevention, education, conservative wound care methods, surgical treatment, and future trends in wound healing related to post-SCI pressure sores. A change in nomenclature was adopted by the National Pressure Ulcer Advisory Panel in 2016, replacing “pressure ulcer”with “pressure injury.” New concepts of pressure injury staging, such as suspected deep tissue injuries and unstageable pressure injuries, were also introduced. A systematic evidence-based review of the prevention of and therapeutic interventions for pressure sores was also discussed.

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An audit of the physiotherapy management of paraplegic patients with sacral pressure sores

South African Journal of Physiotherapy ◽

10.4102/sajp.v69i4.380 ◽

2013 ◽

Vol 69 (4) ◽

Cited By ~ 1

Author(s):

D. Pather ◽

W. Mudzi

Keyword(s):

South Africa ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Bed Rest ◽

Pressure Sore ◽

Patient Treatment ◽

Pressure Sores ◽

Western Cape ◽

Treatment Practice ◽

Cord Injury

Introduction: Pressure sores are the most common complication post spinal cord injury that requires patients to be on bed rest. Patient bed rest delay rehabilitation and may lead to other complications associated with immobility. This study sought to establish the treatment interventions physiotherapists provide to patients with sacral pressure sores and the factors that they consider when deciding whether the patient should receive physiotherapy in the ward or gym. Methods: This was a questionnaire based survey of physiotherapists working in spinal cord injury rehabilitation units in South Africa. The self-designed questionnaire was sent to all the main spinal rehabilitation units in the country (14) located in Gauteng, Kwa-Zulu Natal, Western Cape, Eastern Cape and Free State provinces. Results: Thirty-nine physiotherapists from a total of 51 completed the questionnaires (76% response rate). The most common treatment practice for patients with sacral pressure sores was bed rest (98%). The most common physio-therapy practices (70%) included were upper limb muscle strengthening, upper and lower limb passive movements, positioning into prone and side lying and passive stretching. The choice of treatment environment was influenced by doctors’ orders and the size, grade and duration of the pressure sores. Conclusion: Direct involvement in pressure sore management in South Africa seem to be less than in other parts of the world. If we are to minimise the pressure sore impact, it appears like we need more focus on gait re-education and standardised ADL programmes and patient treatment in the gym to possibly maximise healing and rehabilitation.

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Correlation of spinal cord injury with development of spinal arachnoid cysts: Two case reports

Journal of Rehabilitation Medicine – Clinical Communications ◽

10.2340/20030711-1000066 ◽

2021 ◽

Vol 4 (1) ◽

pp. jrmcc00066

Author(s):

K Raes ◽

K Oostra

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Case Reports ◽

Arachnoid Cysts ◽

Cord Injury

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Management of Sacral Pressure Sore by Clinically Isolated Superior Gluteal Artery Perforator-based Fasciocutaneus Flap in Patients with Spinal Cord Injury

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-27-1-14 ◽

2016 ◽

Vol 27 (1) ◽

pp. 14-18

Author(s):

S P Das ◽

Mamtamanjari Sahu ◽

Pramod Kumar Parida

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Constant Pressure ◽

Spinal Injury ◽

Wound Dehiscence ◽

Pressure Sore ◽

Superior Gluteal Artery ◽

Doppler Probe ◽

Cord Injury ◽

Artery Perforator

Abstract Prolong confinement to bed in spinal injury patients imparts constant pressure on bony prominences resulting impairment of blood flow to local tissue. Constant pressure of 2 hours or more produces irreversible changes leading to tissue necrosis and development of pressure sore. Sacrum encounters highest pressure in supine position and is the commonest site of pressure sore in spinal cord injury patients followed by trochanter and heel. Objective of the study Observation on management of sacral pressure sore by superior gluteal arterial perforatorbased flap using anatomical land marks in the absence of facility of Doppler probe for isolation of superior gluteal arterial perforators. Materials and methods Thirteen patients of spinal cord injury presented with sacral pressure sore were managed surgically using superior gluteal artery perforator-based flap coverage. The location of the artery was identifi ed using anatomical land marks. In 10 patients the flap was heeled uneventfully, one had signifi cant complication with wound dehiscence. Conclusions Management of sacral pressure sore by superior gluteal arterial perforator-based flap using anatomical land marks is a simple and reliable procedure. The learning curve is not that stiff. Sophisticated instruments are not required for this procedure.

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Solifenacin-induced acute urticaria and angioedema: a rare adverse effect

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-138375 ◽

2021 ◽

pp. postgradmedj-2020-138375

Author(s):

Umer Younas ◽

Omar Shafiq ◽

Sahibzada Nasir Mansoor ◽

Muhammad Tawab Khalil

Keyword(s):

Adverse Effect ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Complete Resolution ◽

Case Reports ◽

Temporal Association ◽

First Line ◽

Drug Induced ◽

Acute Urticaria ◽

Cord Injury

Antimuscarinics are first-line medication for management of overactive bladder with solifenacin being commonly prescribed. Angioedema is the swelling of mucosa and submucosal tissue. There are no published case reports of drug-induced angioedema involving solifenacin. We report a case of a 41-year-old man with spinal cord injury who presented with oedema of face, lips, tongue and associated pruritic urticaria after taking 5 mg of solifenacin. All other possible causes including food allergy, insect bite, hereditary angioedema, use of NSAIDs, ACE inhibitors and antibiotics were ruled out. The temporal association between solifenacin and angioedema and complete resolution of symptoms after discontinuing the drug suggest that solifenacin was the most probable cause of angioedema in our patient.

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