Biochemical changes in skin composition in spinal cord injury: a possible contribution to decubitus ulcers

Patients with spinal cord injury (SCI) have an increased susceptibility to ulcers of the skin due to pressure. Immediately after the injury, SCI patients have a greatly increased degradation of collagen from both bone and skin. Loss of collagen from the skin could account for a reduction of the skin's ability to resist mechanical insults. This paper describes the results of an investigation into the role of collagen metabolism in the etiology of pressure ulcers. Skin biopsies have been obtained from healthy non-paralysed volunteers, and from insensitive and sensitive skin in SCI patients. The amino acid content of the insensitive skin was considerably lower than in sensitive skin. The activity of the enzyme lysyl hydroxylase was also lower in the insensitive skin. Lysyl hydroxylase activity in the sensitive skin was similar to enzyme activity in control skin biopsies of the same body area.