Association between pressure sores and immobilization in the immediate post-injury period

Pressure sores are a frequent complication of spinal cord injury (SCI) and are assumed to result from insufficient rotation following admission to the acute care unit. The likelihood of pressure sores occurring before admission to the nursing unit is not usually recognized. This study attempts to determine whether pressure sores are associated with prolonged immobilization in the early post-injury period, before admission to the acute care ward, and to identify other etiological factors relating to evacuation, transportation, and emergency room treatment. Thirty-two SCI patients were studied, 16 of whom developed sores in the hospital, and 16 who did not. Excluding five patients who failed to recall their immediate post-injury care, none of the remaining 14 patients with sores recalled being turned within two hours of injury; all 13 patients without sores said that they were rotated within two hours. Almost all patients said they were first turned on the hospital ward by a nurse. Whereas most of those without sores took less than two hours to reach the ward, most of those who later developed sores took three hours or longer.