Pressure Ulcers in Pediatric Spinal Cord Injury

Hickey, Kathryn J; Anderson, Caroline

doi:10.1310/1c86-7l96-1jar-7y3n

Cited by 9 publications

(5 citation statements)

References 2 publications

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“…14 In a previous retrospective review of pediatric SCI from our institution, 55% of participants injured at age 12 years and younger had experienced at least one pressure ulcer; it was also found that those with paraplegia were more likely to develop pressure ulcers than those with tetraplegia. 16 This is similar to our findings of 41% of participants overall with a history of pressure ulcers. Additionally, we too found that those with paraplegia were more likely to experience pressure ulcers than those with tetraplegia, although the difference did not reach statistical significance (p=0.053).…”

Section: Discussionsupporting

confidence: 91%

“…In previous studies of adults, it has been shown that 50 to 80% of those with SCI will develop a pressure ulcer at some point after their injury 14 . In a previous retrospective review of pediatric SCI from our institution, 55% of participants injured at age 12 years and younger had experienced at least one pressure ulcer; it was also found that those with paraplegia were more likely to develop pressure ulcers than those with tetraplegia 16 . This is similar to our findings of 41% of participants overall with a history of pressure ulcers.…”

Section: Discussionsupporting

confidence: 88%

“…There were 116 pressure ulcers, with some participants having ulcers in more than one area. The most common sites for ulcers were the foot and ankle (45), sacrum (16), knees (16), ischium (10), and hips (8).…”

Section: Skeletal Complicationsmentioning

confidence: 99%

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Spinal cord injuries in young children: a review of children injured at 5 years of age and younger

Schottler

Vogel

Sturm

2012

Develop Med Child Neuro

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ABBREVIATIONS AISASIA Impairment Scale DVT Deep venous thrombosis SCI Spinal cord injury SCIWORA Spinal cord injury without radiological abnormalities AIM To determine the epidemiology and complications of spinal cord injuries (SCIs) in children injured at 5 years of age and younger who were seen between 1981 and 2008 at a children's hospital in the USA.METHOD Complications studied were scoliosis, hip dysplasia, latex allergies, autonomic dysreflexia, pressure ulcers, spasticity, deep venous thrombosis, and kidney stones. Demographic and injury-related factors included age at injury, etiology, level of injury, American Spinal Injury Association Impairment Scale (AIS), and SCIs without radiological abnormalities (SCIWORA). RESULTSOf the 159 individuals seen (92 males, 67 females) median age at injury was 2 years (range 0y-5y 11mo). Forty-nine percent were injured in vehicular accidents, 60% had complete injuries, 66% had paraplegia, and 72% had SCIWORA. Ninety-six percent developed scoliosis, 57% had hip dysplasia, and 7% had latex allergy. Thirty-four percent with injuries at or above T6 experienced autonomic dysreflexia, 41% developed pressure ulcers, and 61% experienced spasticity. Of those without bowel or bladder control, 82% were on intermittent catheterization and 69% were on a bowel program. Median age of initiating wheelchair use was 3 years 4 months (range 1y 2mo-12y 5mo). Twenty-four were community ambulators, and they were more likely to have AIS D lesions (half the key muscle functions below the level of injury have a muscle grade 3 or greater) and less likely to have skeletal complications. INTERPRETATIONThe epidemiology, complications, and manifestations of SCIs in children injured at a young age are unique and differ distinctively from adolescent and adult-onset SCIs.Spinal cord injuries (SCIs) are an uncommon occurrence in children aged 5 years and younger but can have a devastating effect on the children and their families. The impact of an SCI in all spheres of life in such young children is immense in view of their relatively long life span and the mutual interaction of SCIs and growth and development. Younger children have relatively unique etiologies for their SCI, such as lap belt or birth injuries, and unique pathophysiology of their injuries, including SCIs without radiographic abnormalities (SCIWORA). Compared with adults and adolescents, younger children who sustain SCIs are more likely to have paraplegia or complete injuries. 1,2 Children who sustain an SCI at a young age are at high risk of a variety of complications such as scoliosis and hip dysplasia.2 In addition, because of their young age at injury and relatively long lifespan, they will most likely be at risk for a variety of aging-related complications throughout their life, including overuse syndromes and cardiovascular disease. 3,4 The purpose of this study is to describe injury-related factors, demographic information, and the incidence of secondary complications that develop in children who sustained an SCI at 5 years of ag...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

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Spinal cord injuries in young children: a review of children injured at 5 years of age and younger

Schottler

Vogel

Sturm

2012

Develop Med Child Neuro

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“…The ICF model not only gives a holistic basis for therapists to evaluate their own activity, but also encourages more adequate communication with other healthcare professionals and provides a means of interactive and meaningful discussions with children and their families. [26][27][28][29][30][31][32]…”

Section: Discussionmentioning

confidence: 99%

Review of pressure ulcers management in pediatrics: assessment, prevention, and intervention

Sarsak¹

2018

JPNC

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Objective: This study did a thorough review of the literature and investigated the current evidence-based guidelines and information available for the incidence and prevalence, the identification of risk factors, which risk scales are valid and reliable, and examined the effectiveness and applicability of the different intervention and prevention options for the management of Pressure Ulcers (PUs) and skin breakdown in pediatric population in comparison to those found in adults literature.Results: PUs in the pediatric population has been poorly documented and has not received adequate attention in the literature compared to those in the adult population. The chronically ill children and the pediatric patient population with chronic conditions and severe neurological and sensory motor impairments such as cerebral palsy, spine bifida and Spinal Cord Injury (SCI), are at significant risk for the development of PUs. A comprehensive and thorough pediatric skin care program should emphasize the need for accurate, continuous assessment, including specific and detailed documentation of tissue damage. Early assessment and detection are essential because early stage PUs is far easier and less costly to treat. Currently, there are 10 published pediatric pressure ulcer risk assessment scales. Of these scales, only the Braden Q Scale, the Neonatal Skin Risk Assessment Scale (NSRAS), and the Glamorgan Scale have been tested for sensitivity and specificity. Conclusion:Most of the current evidence-based guidelines for prevention and management of pediatric PUs have been relatively limited and are largely modifications of adult practice guidelines. Healthcare professionals should keep in mind that pediatric patients are not just small adults, but deserve unique consideration in their medical and surgical care. Therefore, further future research studies and well designed randomized clinical trials (RCTs) are needed to examine the efficacy, effectiveness, the applicability, and safety of the available prevention and treatment options for the management of PUs and skin breakdown in pediatric population.

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“…Pressure injuries are one of the most common complications for youth with SCI. 18,19 Toddlers and younger children may be at risk because of inadvertent trauma from activities and play typical of these age groups. Preventive interventions should be developmentally based, with responsibility gradually shifting from parents to the youth.…”

Section: Pressure Injuriesmentioning

confidence: 99%

A Primary Care Provider’s Guide to Pediatric Spinal Cord Injuries

Zebracki

Melicosta

Unser

2020

Topics in Spinal Cord Injury Rehabilitation

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Spinal cord injury (SCI) in youth presents with unique manifestations and complications as compared to adult-onset SCI. The primary care clinician must consider the physical, physiological, cognitive, and psychological changes transpiring during childhood and adolescence. Physical changes include increasing size, weight, and bladder volume. Physiologic considerations include decreasing heart rate and increasing blood pressure with age. Cognitive issues include communication, executive functioning, and self-management skills. Lastly, psychological processes involve emotional functioning and establishment of self-identify and autonomy in the context of life with SCI.

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Pressure Ulcers in Pediatric Spinal Cord Injury

Cited by 9 publications

References 2 publications

Spinal cord injuries in young children: a review of children injured at 5 years of age and younger

Spinal cord injuries in young children: a review of children injured at 5 years of age and younger

Review of pressure ulcers management in pediatrics: assessment, prevention, and intervention

A Primary Care Provider’s Guide to Pediatric Spinal Cord Injuries

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