Pressure ulcers in people with spinal cord injury in developing nations

Abstract

Study design: Literature review. Objectives: To explore the prevalence or incidence, risk factors, and costs of pressure ulcers among individuals with spinal cord injury (SCI), specifically in the context of the developing world. To highlight important targets for intervention and research for pressure ulcer management the world over. Setting: World Bank 'low-income' and 'middle-income' countries with a gross national income per capita o$12 746. Methods: PubMed search. Results: SCI-associated pressure ulcers are very prevalent in developing nations; however, reported prevalence and incidence numbers are highly variable. Risk factors for pressure ulcers are similar in developed and developing countries however many of the risk factors are more prevalent in developing nations. Conclusion: SCI-associated pressure ulcers are common but can be prevented in the developing world. Key targets for interventions include acute care, nurse-to-patient ratios, support surfaces and education.

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

“…Like in many low and middle income countries [4,30] pressure sores were the most prevalent complications in this study. Lack of pressure relief knowledge, skills, manpower and necessary tools have been identified as factors to the increase of pressure sore incidents [4,14].…”

“…Lack of pressure relief knowledge, skills, manpower and necessary tools have been identified as factors to the increase of pressure sore incidents [4,14]. The consequences of pressure ulcers include increased LOS, re-hospitalization and increased rehabilitation expenses.…”

“…The consequences of pressure ulcers include increased LOS, re-hospitalization and increased rehabilitation expenses. Pressure ulcers are also a common cause of death to persons with spinal cord injury in many lower income countries [4,14,31]. The magnitude of pressure ulcers, respiratory complications and urinary tract infections partly explain the high in-hospital mortality of 24.4% of all TSCI admissions [32].…”

“…A person with spinal cord injury is at immediate risk of respiratory and cardiac failure which may lead to death in the acute phase [3]. Those who survive the acute phase, faces a lifelong risk of secondary complications such as pressure ulcers, urinary tract infections, deep venous thrombosis, contractures, chronic pain and spasms [1,4]. …”

Global neurotrauma research challenges and opportunities

“…Crucial aspects, such as the relationship between pre-hospital care and outcomes for patients with SCI are difficult to analyse in LMICs because pre-hospital care is not widely available 50 . An example of the difficulties in SCI research owing to a lack of data is presented in a review about pressure ulcers as a complication in patients with SCI in LMICs 51 . Over the past few years, researchers in China have been making important steps towards evaluating cellular therapies and improving the quality of life of those with SCI.…”