Integral multidisciplinary approach in a patient with chronic complete spinal cord injury and hip disarticulation

Abstract

STUDY DESIGN: Case report. OBJECTIVES: To highlight the importance of the integral multidisciplinary management of a patient with complete chronic spinal cord injury and hip disarticulation secondary to pressure ulcers (PU). SETTING: Mexico City. METHODS: The case of a 40-year-old male violinist with a spinal cord injury, American Spinal Injury Association Impairment Scale A and neurological level T4, is reported. The patient initiated with bilateral ischiatic, left trochanteric and sacral PU. The ulcers were complicated with infection with sluggish evolution. Thus, it was decided a multidisciplinary management by means of left hip disarticulation and elaboration of a cosmetic prosthesis and the manufacture of a viscous elastic foam cushion for the prevention of new PU. The patient was quickly included in his professional and social activities. INTRODUCTIONThe presence of chronic pressure ulcers (PU) can generate, in the patient with spinal cord injury (SCI), a significant impact on health, functionality and quality of life (QOL).1 The annual incidence of PU in patients with SCI is 23-33% and it is estimated that between 85 and 95% of patients with SCI will present at least one PU in their lifetime, and that 70% will present multiple PU.