Defective wound healing in patients with paraplegia and quadriplegia

Patients with paraplegia and quadriplegia have a startlingly high incidence of healing problems in pressure protected wounds below the level of spinal denervation, suggesting clinically important defects in wound healing below the level of complete spinal neurologic loss. Healing of these wounds was, in fact, comparable with that of decubitus wounds in paraplegic patients in this study. Both groups of denervated wounds had significantly more complications of healing than did wounds above the level of spinal loss or wounds in nonparaplegic patients. Additional investigation is needed to explain and further delineate the apparently defective wound healing in these patients, which should not be attributed solely to pressure injury or chronic infection as it has in the past.