Special Concerns

Taking extra care for skin care

Some special concerns can emerge after injury, often related to absent or limited movement and feeling or sensation.

Be sure clothes are not too tight.
Be careful in wearing clothes with lots of stitching, pockets, zippers, and snaps that might cause pressure marks on the skin.
Always wash new jeans to soften them before wearing.
Wear natural-fiber clothing, such as cotton, because it breathes better, absorbs moisture, and allows air to come in contact with your skin.
Dress for the outside temperature. Wear layers so you can adjust to different temperatures easily.
Don’t wear tight hose or socks unless they are support hose.
You may prefer to not wear underwear if the elastic or seams bother your skin.

Inspect the feet, ankles, toes, and toenails every day.
Keep toenails clean and cut them straight across. Ingrown nails can cause infection.
Wash and completely dry the feet every day.
Use a vinegar soak to remove calluses.

Hot water: Always test water first with a part of your body that has normal feeling or sensation. Set your water heater at 120 degrees Fahrenheit or less. Cover exposed hot water pipes under the sink with insulating foam.
Space heaters: Keep a safe space away to avoid burn risk.
Sun: Wear sunscreen on all exposed areas, especially over old scars. Wheelchair users should be mindful that the sun can cause parts of the chair to become hot, posing a burn risk. Never leave Ankle Foot Orthosis (AFO) braces out in the sun, as they will melt if they get too hot.

If you have just bought new shoes or this is the first time wearing shoes since your injury, slowly increase the time you wear them.
- Start with 30 minutes. Take the shoes off and check the feet for redness or dark areas. Pay special attention to areas over the heel, ankle, and toes.
- If the skin is OK, wear shoes for an hour the next time. Check the skin again for redness or dark areas.
- If the skin is OK, add one hour each day until 10-12 hours are reached.
- If the skin remains OK, you can now wear your new shoes all day.
- Continue to check the feet each time you take the shoes off.
Avoid hard leather shoes. Softer leather is best because it tends to stretch more.
If a red or dark spot is present when doing a skin check, a larger size shoe may be needed. Stop wearing the shoes until the red or dark spot goes away.
If you’re unable to walk, buy shoes 1- to 1.5-sizes bigger than usual. If you are wearing a brace inside your shoe, you may need to wear a shoe two sizes larger than usual. This is important because the feet may swell after the injury. If shoes are too tight, the skin on the feet can develop blisters or sores. Check your feet carefully before you put on your shoes, and don’t wear shoes if there is a sore.

Always wear a seatbelt.
Sit on your wheelchair cushion when in the car unless a different cushion has been prescribed for you.
Wear shoes when traveling so your feet will not get too hot touching the vehicle floorboards.
If you have a sore on your feet, protect the feet by resting them on a pillow.
Do scheduled weight shifts when traveling in a car or other mode of transportation.

Prepare a mixture of 1 quart of water and 2 teaspoons of table salt.
Heat until it comes to a boil.
Store normal saline in a clean, sterile jar. The jar and lid should be cleaned and sterilized as for canning or preparing baby milk bottles.
Make normal saline fresh every day.

Apply a solution of one part warm water to one part white vinegar to a towel.
Wrap the affected hands and feet in the towel for 20-30 minutes.
Scrub the affected extremity with the same towel. Rinse, dry, and apply a moisturizing cream.
Do this once a day for three days.
Do not do this if there are open sores on the skin in the affected extremity.