Skin and Sensation

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Protecting your skin:

In an individual with spina bifida some of the nerves do not develop properly, which results in little or no sensation in some areas of the skin. Without the warning of discomfort or pain from heat, cold, sharp objects, pressure, scrapes or excessive moisture an individual will be unaware of damage to their skin. A sore may develop quite quickly and can worsen rapidly if not attended to properly.

Children need to learn the importance of personal hygiene to their overall well being. Parents should begin teaching skin care to their child at an early age, until their routine becomes second nature:

• Perform regular self checks of the skin, using a hand held mirror to view those areas not easily seen with the eyes.
• Keep skin clean and dry. Moisture and chemicals from urine, bowel material or sweat can damage the skin if left there too long.
• Eat nutritious foods and drink plenty of fluids to keep the body and skin healthy.

Pressure sores:

Red patches can be caused by prolonged pressure on an area of the skin. When the redness disappears within 30 minutes, it is usually not a cause for concern. However, if redness in the same spot persists from day to day or takes longer than 30 minutes to disappear, the area needs medical attention.

Pressure sores are typically found:

• Buttocks and sacrum from prolonged sitting in a wheelchair
• Heels and ankles from ill-fitting or incorrectly applied splints

Red areas can develop into very nasty sores if not treated early and effectively, and can in some cases take months or years to heal. Treatment must always involve removing the pressure.

How to prevent pressure sores:

• Regular bottom lifts / shifting of weight while in the wheelchair
• Use of a sheepskin or pressure relieving cushion on wheelchair seat
• Take care with the surface that the child is sitting on, make sure that there is nothing in back pockets of pants, etc.
• Regular checking of heels, ankles, etc. for red areas from splints
• Beware of problems like sand getting into splints (abrasive effect)

For more information:

• Coming soon: Bitsy & Bumby Bottom tell you how to stop those pressure sores! Written by Jenny Aikenhead (ACH physiotherapist) and Stephanie Birkett (ACH clinic resource nurse)
• How to avoid pressure sores (ASBAH)