Individuals with restricted mobility or sensation such as those that are wheelchair bound due to a spinal cord injury or those that sit in a posture which places greater pressure on one buttock/thigh or the other, can develop pressure sores and associated complications.
Pressure sores develop if excess pressure is placed over areas where bone is close to the skin surface or where areas of skin are in close contact. If an individual has lost the capacity to sense that they need to change positions, or they are physically unable to change positions independently, damage to the skin can occur through restriction of the blood supply to that area. Common areas for pressure sores are the buttocks, thighs, groin, between the toes or on areas where splints are worn. Moisture can also contribute to pressure areas.
Workplace Solutions and adjustments
Within the workplace appropriate pressure care needs to be addressed to ensure individuals are not only comfortable whilst working and therefore able to work more productively, but are also not worsening their medical conditions.
Some things to take into consideration within the workplace for individuals who are wheelchair bound or have restricted mobility or sensation and are prone to developing pressure sores include:
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provide opportunities for individuals to relieve pressure on ‘at risk’ areas—this may include; changing pressure from one buttock to the other, bending forwards or backwards, pushing up on the arms of the chair or wheelchair
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ensure that if it is possible, individuals transfer from their wheelchair to a supportive office chair within the workplace
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ensure adequate cushioning and postural support is provided by the wheelchair or office chair whilst minimising pressure areas
- ensure footplates on wheelchairs or footrests under desks are adjusted appropriately to relieve pressure from the back of the thigh
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ensure ensure splints and braces fit well and are not rubbing
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consider the clothing worn to work, as if clothes are too tight they can restrict circulation and if they are too loose the excess fabric can place pressure on the skin
A range of products and aids are also available to assist in pressure care management including:
The supports and aids mentioned here should all be used according to medical advice and regular checks of skin are still required to ensure pressure care is being adequately managed.
Relevant Links
Independent Living Centres Australia Inc. <http://www.ilcaustralia.org/home/default.asp>
ParaQuad NSW: Carer’s Training Resource Kit <http://www.paraquad.org.au/Resources/ParaQuadpublications/FactSheets/CarersTrainingResourceKit.aspx>
References
Independent Living Centres Australia Inc 2007, Independent Living Centres Australia Inc, Sydney, viewed 29 June 2007, <http://www.ilcaustralia.org>.
Northwest Regional Spinal Cord Injury System 2007, Maintaining Healthy Skin – Part 2, University of Washington, Seattle , viewed 29 June 2007, <http://sci.washington.edu/info/pamphlets/skin_2.asp>.
Paraquad NSW 2007, Personal Care Procedures, Paraplegic & Quadraplegic Association of NSW, Newington, viewed 29 June 2007, www.paraquad.org.au/uploads/files/1132125118125_0.3249507923493308.pdf.
Paraquad NSW 2005, An Overview of Skin and Pressure Area Management: In Adults with Spinal Cord Injuries, Paraplegic & Quadraplegic Association of NSW, Newington, viewed 29 March 2010, <http://www.paraquad.org.au/site/DefaultSite/filesystem/documents/fact_sheets/health_pros/Skin%20management.pdf>.