Psychological factors in the causation of pressure sores: case report

Heilporn, André

doi:10.1038/sc.1991.19

Cited by 11 publications

(9 citation statements)

References 4 publications

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“…According to the existing literature in this regard, PU are more frequent and have a worse prognosis than that of non-SCI patients. 10,11 In some SCI patients, negligence in skin care associated to depressive states, neurotic-anxious personality and low satisfaction in their daily life have been described. 9,10 This condition, present in less than 1% of the SCI patients, has been called 'ectodermic syndrome' and presents several characteristic psychological elements.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 This condition, present in less than 1% of the SCI patients, has been called 'ectodermic syndrome' and presents several characteristic psychological elements. 11 It is described as a negation of the SCI with facts, associated with the incapacity of understanding the condition and reflected in a lack of attention in skin self-care.…”

Section: Discussionmentioning

confidence: 99%

“…9 When this occurs, patients must be hospitalized for long periods and must undergo multiple surgical procedures that severely decrease their quality of life patients and that of their families. 10,11 Hemipelvectomy is a procedure exceptionally performed; it is extreme and generally used in oncological surgery. Mortality associated to surgery is 2-3%.…”

Section: Introductionmentioning

confidence: 99%

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Proximal amputation of inferior extremity secondary to recurrent pressure ulcers in patients with spinal cord injuries

et al. 2007

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Study design: Descriptive case series study. Objective: To describe the course of five spinal cord injury (SCI) patients who underwent proximal amputation of the inferior extremity, secondary to recurrent, complicated pressure ulcers (PU) and the clinical impact this intervention had in these patients. Place: Trabajador Hospital in Santiago, Chile. Method: Revision of five clinical cases of patients who underwent partial hemipelvectomy or hip disarticulation with amputation of the extremity as treatment for pelvic recurrent PU with chronic secondary osteomyelitis. The clinical impact was quantified as days of hospital stay, number of surgeries and previous and post surgery PU. Results: After the proximal amputation of the extremity, patients significantly decreased number of days of hospital stay (P ¼ 0.035), number of surgeries (P ¼ 0.015) and PU (P ¼ 0.0065). Conclusion: Partial hemipelvectomy and hip disarticulation with proximal amputation of the inferior extremity are rescue procedures that can be last resource treatment for chronic recurrent pelvic PU secondary to chronic osteomyelitis. Sponsorship: Not applicable.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Proximal amputation of inferior extremity secondary to recurrent pressure ulcers in patients with spinal cord injuries

et al. 2007

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“…1 When patients are functionally very dependent, the risk of pressure sores is most likely linked to the educational level of both the patient and the caregivers rather than to the neurological level itself. Psychiatric disorders 5 are also known to be major risks factors, and they can contribute to a lack of follow-up that could also be, in our opinion, a primary determinant of severity. The combination of risk factors and management of the various complications resulted in long hospital stays.…”

Section: Discussionmentioning

confidence: 99%

Sepsis of the hip due to pressure sore in spinal cord injured patients: advocacy for a one-stage surgical procedure

et al. 2014

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Study design: Retrospective study reporting characteristics and management of septic arthritis of the hip due to pressure sores in spinal cord-injured patients. Objectives: To describe clinical and biological data of septic arthritis of the hip and its treating management. Setting: The database of the regional SCI referral center, Nantes, France. Methods: We retrospectively collected data from 33 cases of septic arthritis of the hip in the medical files of 26 patients. Results: We analyzed 33 cases of septic arthritis of the hip treated in one French referent center for spinal cord-injured patients from January 1988 to December 2009. Most patients had a thoracic complete paraplegia and nearly two-third (17 out of 26) had no systematic follow-up. In 25 out of 33 cases, the septic arthritis of the hip was due to a trochanteric pressure sore. The causal pressure sore was most frequently associated with a persistent drainage. The standard radiological examination led to the diagnosis in 30 cases and, in 7 questionable cases, magnetic resonance imaging was more contributory. Surgery always consisted of a wide carcinologicallike excision and of a subtrochanteric proximal femoral resection including both greater and lesser trochanters. A musculocutaneous flap was realized for all cases and the choice of the muscle depended on the localization of the causal pressure sore but also of the remaining choices, as most of the patients had already undergone a prior surgery. An antibiotic treatment was adapted to multiple samples during surgery. Conclusion: We do advocate for a one-stage procedure including a subtrochanteric proximal femoral resection and a musculocutaneous flap.

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“…[2][3][4]7,20 Potential risk factors for the development of PU are noncompliance with prevention measures, being in a noncollaborating environment, emotional stress, being single, poor responsibility for skin hygiene, low satisfaction with the activities of daily living (ADL), poor self esteem 3,4,6,7,21 and personality disorders. [22][23][24] Lack of education, of a job, no group activities, no sexual activity and others are also associated to PU occurrence in SCI patients. 6,7,25 Heilporn 24 described a mental disorder in these patients, which he called Ectodermic Syndrome, characterized by repeated PUs, inability to understand the importance of skin care, rejection of the condition of being disabled and being refractory to mental treatment.…”

Section: Introductionmentioning

confidence: 99%

Predictive factors for pressure ulcers in the ambulatory stage of spinal cord injury patients

et al. 2006

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Study Design: Case control study. Objective: To determine the main risk factors for pressure ulcer (PU) in ambulatory spinal cord injury (SCI) patients. Setting: Hospital del Trabajador, Santiago, (ACHS (Chilean Security Association), Chile. Methods: We studied 41 patients for traumatic SCI, from Santiago, Chile, cared for in our hospital. The clinical histories were reviewed from first discharge to 1996. The patients were categorized into two groups: 18 cases with a previous history of PU, and 23 patients with no history of PU were considered as controls. Univariate analysis was performed, 18 variables per case, 10 of which were psychosocial factors. Results: There were 37 men and four women. Average age was 41.7 years. Duration of SCI on average was 6.7 years. The distribution was complete paraplegia (CPP) 22 patients (54%), complete tetraplegia three patients (7%), incomplete paraplegia 11 patients (27%) and incomplete tetraplegia, five patients (12%). Four variables of the univariate analysis were significant: duration of cord injury (SCI time) 45 years, completeness of cord injury, paraplegia and not able to practice regular standing. There was a significant association in body morphology (endo or ectomorphic), being able to practice regular standing and personality disorder in CPP. Conclusions: The risk for developing PU was 4.3 times greater in CPP patients than is any other type of SCI. CPP patients who do not practice standing periodically, who have a personality disorder and have an ecto/endomorphic corporal morphology have a greater risk of suffering PU.

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Psychological factors in the causation of pressure sores: case report

Cited by 11 publications

References 4 publications

Proximal amputation of inferior extremity secondary to recurrent pressure ulcers in patients with spinal cord injuries

Proximal amputation of inferior extremity secondary to recurrent pressure ulcers in patients with spinal cord injuries

Sepsis of the hip due to pressure sore in spinal cord injured patients: advocacy for a one-stage surgical procedure

Predictive factors for pressure ulcers in the ambulatory stage of spinal cord injury patients

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