Managing skin health in obese children with spina bifida: an overview and case study

Chronic wound and skin care issues in obese children tend to occur in specific disease-related groups such as patients with neural tube deficits. While the incidence of neural tube deficits has declined as a result of increased awareness about the importance of prenatal folic acid intake, neural tube deficits remain some of the most common congenital anomalies. General care of spina bifida patients must address their physical limitations, structure, decreased sensation, limb weakness, and psychosocial needs related to dependence on others and being "different." Patients and their families also face the challenge of preventing and treating skin breakdown. As illustrated in the case study of one 14-year old patient, wounds occur and recur for a wide variety of physical, social, and environmental reasons. When skin breakdown occurs, a multidisciplinary team approach that incorporates physicians, physical and occupational therapists, nutritionists, social workers, and wound care specialists has been found to be most effective in restoring skin integrity. Patient and family, as well as healthcare providers with whom they interact, need to be educated on the complexities of care provision. Additional research into specific conditions related to this population to help healthcare professionals provide evidence-based care is needed.