Causes and Signs

Some conditions to watch out for

Skin problems can emerge after injuries. Issues with the skin can also be caused by poor nutrition, smoking, dry and flaky skin, and poor hygiene. General signs of common skin problems can include:

Any change in the color of the skin, notably including reddened or darkened areas
Swelling
Raised or hardened areas
Bruises
Warm areas felt near a red, dark, raised or hardened area
Blisters
Rashes
Any opening on the skin

It is important to check the skin at least twice a day. Skin checks are quick and easy to do and will save the skin from unwanted skin sores.

Here are some of the skin conditions that can occur more frequently for persons being treated after injuries.

Accident risks

Accidents can also happen. They include bumps, bruises, cuts, and burns that injure the skin. Since feeling may be decreased or absent after some injuries, a person may not even know that an injury occurred during an accident.

Burns can happen during everyday activities, from bumping into a stove to spilling a hot drink on yourself. The skin may look red and angry, and blisters sometimes form. Treat burns by moisturizing skin with aloe products. Do not pop blisters but keep them protected.
Bumps can happen during everyday activities, from scraping your foot on a doorway to jamming your finger. Watch for swelling and redness. Treat bumps by taking extra care and call your doctor if they become hot and swollen. Take extra care with movements. If using a wheelchair, attach a lapboard when cooking or carrying hot food, and attach a cup holder for hot liquids. Cook on the front burners so you do not have to reach over hot surfaces, if possible.

Excess moisture

Excess moisture can cause the skin to become waterlogged, a condition called maceration. It can soften the skin too much and make it more likely to break down and become a sore. Your skin may appear wet, pale, and wrinkly. Control moisture by:

Performing bladder and bowel programs on time and completely to avoid accidents
Cleaning the skin right away if bowel or bladder accidents happen
For men, wearing a condom catheter in case of reflex in between bladder programs
Drying off sweat from activity or fever
Changing bathing suit after swimming to avoid sitting in wetness for long periods
Using petroleum jelly on buttocks area if diarrhea is a problem

Call your doctor if you are leaking urine in between bladder programs.

Pressure

Pressure on the skin from body weight happens when a person stays in one position for too long. It’s the biggest cause of skin breakdown and sores because it decreases blood flow to the skin.

It’s most likely to occur over bony areas where there is not much padding between the skin and the bones, such as at the back of the head and on the heels of your feet. Affected areas may look red or bruised.

Pressure can be caused by everyday activities such as:

Sitting or lying in one position for long periods
Wearing clothes or shoes that are too tight
Sitting on unpadded surfaces
Wearing casts or splints that are too tight
Using a wheelchair that is the wrong size
Not using a properly adjusted wheelchair cushion

Pressure problems can be prevented by routine habits such as:

Changing your position frequently
Doing weight shifts correctly and on time
Wearing properly fitting clothes and shoes
Checking skin under splints regularly and removing them if you notice red spots
Calling the doctor promptly when skin breaks down
Using properly fitted wheelchair and cushion
Inspecting wheelchair regularly for wear and tear

Shearing

Shearing, which looks like a scrape, can remove the first few layers of skin cells. This can happen when something stretches or pulls on the skin. This also leads to decreased blood flow to the skin and deeper tissues under the skin.

It can occur as a result of:

Sitting in bed too long
Sliding the body over a surface such as when doing a transfer or raising up in bed
Slumping in the wheelchair

Friction

Friction occurs when the skin is rubbed hard across another surface. Friction can result in an open area on the skin. Friction can be caused by:

Any movement that causes a body part to rub across another surface
Performing a sliding board transfer incorrectly and rubbing the buttocks over the wheelchair tire

To avoid shearing and friction:

Take extra care with movements.
Apply lotion to keep the skin healthy.
Wear properly fitting shoes.

Swelling

Swelling of the limbs, usually the hands or feet, can result from absent or limited movement. Extra body fluids collect in the limbs and make the skin very fragile. Ways to decrease swelling include: