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Risk factors for pressure sores in adult patients with myelomeningocele--a questionnaire-based study
Pål-Erik Plaum1, Gunnar Riemer, Kathrine Frey Frøslie
1TRS-A National Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, N-1450 Nesoddtangen, Norway. pal-erik.plaum@sunnaas.no
Insights
Adults with myelomeningocele (MMC) and sensory deficits face a higher risk of pressure sores, especially those with memory problems or Arnold Chiari malformation. Improved skin care routines are crucial for this vulnerable patient group.
Area of Science:
- Neurology
- Dermatology
- Rare Diseases
Background:
- Myelomeningocele (MMC) is a complex neural tube defect impacting the cerebrospinal fluid system.
- Pressure sores are a common complication in individuals with MMC, yet risk factors in adults remain poorly understood.
- This study aimed to identify associations between pressure sores and patient characteristics in adults with MMC to improve management strategies.
Purpose of the Study:
- Investigate risk factors for pressure sores in adults with myelomeningocele.
- Identify patient characteristics associated with pressure sore development.
- Inform improved management and prevention strategies for pressure sores in this population.
Main Methods:
- A structured questionnaire was developed to collect data on sores, medical history, function, and living factors.
- The questionnaire was distributed to 193 patients with MMC registered at a National Centre for Rare Disorders.
- Data from 87 participating patients were analyzed to identify associations with pressure sores.
Main Results:
- 82% of participants reported experiencing pressure sores, primarily on toes and feet in areas of reduced or absent sensation.
- Significant associations were found between pressure sores and memory deficit (p=0.02), Arnold Chiari malformation (p=0.02), and a history of previous sores (p=0.004).
- No significant associations were found with hydrocephalus, syringomyelia, nutritional status, BMI, smoking, physical activity, employment, or living arrangements.
Conclusions:
- Adults with MMC and sensory deficits, particularly those with memory problems and Arnold Chiari malformation, are at increased risk of developing pressure sores.
- This high-risk group requires enhanced skin inspection protocols and specialized wound care.
- Findings highlight the need for targeted interventions to prevent and manage pressure sores in the adult MMC population.
Background:
Myelomeningocele (MMC) is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system. Pressure sores are a frequent complication for patients with MMC. Little is known about the risk factors for pressure sores in adults with MMC. The aim of this study was to investigate an association between the presence of pressure sores and other patient characteristics, in order to develop an improved strategy for the management of sores.
Methods:
A structured questionnaire regarding sores, medical condition, function and living factors was designed and sent to the 193 patients with MMC registered in the year 2003 at TRS, a National Centre for Rare Disorders in Norway.
Results:
Out of 193 total, 87 patients participated and 71 patients (82%) reported sores; 26 (30%) at the time of the interview and 45 (52%) during the last 5 years. Sores were mostly localized on toes and feet and occurred exclusively in regions with reduced or missing sensibility. A significant association was found between sores and memory deficit (p = 0.02), Arnold Chiari malformation (p = 0.02) and a record of previous sores (p = 0.004). Sores were not significantly associated with hydrocephalus, syringomyelia, nutrition, body mass index, smoking, physical activity, employment or living together with other persons. Some patients (18, 21%) reported skin inspection by others and the remainder relied on self-inspection.
Conclusion:
Patients with sensory deficit, memory problems, and Arnold Chiari malformation had a higher risk of having pressure sores. This patient group needs improved skin inspection routines and sore treatment.
