What is different about skin and Spina Bifida?
People living with Spina Bifida can develop skin problems due to limited movement, weak muscles, poor sensation or lack of feeling and often poor circulation.
Signs that there might be a problem include:
- Discolouration of the skin (red, white, brown or purple)
- A red mark which does not fade within 10 minutes.
- Presence of blisters or sores
- Blood on clothing e.g. Underwear and socks.
While everyone needs to take care of their skin, there are a few additional issues for people living with Spina Bifida such as:
Altered or loss of feeling
Due to decreased or altered sensation, a person living with Spina Bifida may not be alerted to potential dangers or differences in temperature and textures (eg. hot, cold, sharp, rough or tight). This means that injuries may occur and simple burns or cuts can lead to wounds that take much longer to heal.
Pressure injury
Pressure injuries are caused by damage to the skin and underlying tissues from constant pressure on areas such as the buttocks, hips, heels and knees. The pressure obstructs the normal flow of blood, oxygen and nutrients to the skin. If untreated, these injuries can develop into deep ulcers that take months to heal. In some cases they need surgical interventions and a long period of hospitalisation.
What can be done to prevent skin breakdown
- Avoid sitting too close to fires
- Do not place hot food and drink directly on your lap
- NEVER use hot water bottles
- Always wear sunscreen, a hat and protective clothing if outdoors for long periods.
- Make sure bath water is not too hot – run cold water first.
- Always check metal connectors on seat belts in cars and on wheelchairs that have been sitting in the sun, as well as metal foot plates.
- Avoid any direct contact with hot surfaces such as metal playground equipment, concrete in the playground or surfaces around swimming pools.
- Check your skin daily!
- Use a mirror every morning and night to check for signs of a skin problem, such as on your bottom and feet.
- Always wear correct fitting shoes or thick socks to protect your feet.
- Dry between your toes after each bath or shower.
- Always check skin after one hour when using new splints, orthoses or shoes to check they are not causing pressure injuries. If you are worried, make an appointment to have them checked and make changes.
- Move and shift your weight regularly to take the pressure off your body.
- Avoid storing objects in the pockets of your clothes or on the seat of your wheelchair.
- Make sure your child’s legs and feet are covered when crawling, for protection.
- Change nappies, pads and pants regularly to avoid skin breakdown from urine and faeces.
- Maintain a healthy weight.
If you use a wheelchair to mobilise, please refer to the “pressure relief” fact sheet for more information about pressure injury prevention.
If you think you have a pressure injury or a problem with your skin, seek urgent medical advice from your GP or contact the Spina Bifida Service.
You can find further information about skin management and Spina Bifida at:
- Think Pressure Care is a great website for pressure injury management www.thinkpressurecare.co.uk
- NSW Agency for Clinical Innovation has Information about pressure injury management and models of care: www.aci.health.nsw.gov.au
- ParaQuad NSW (Paraplegic and Quadriplegic Association of NSW) Factsheet “Your Skin” has information about pressure injury management and prevention www.paraquad.org.au
- The Sydney Children’s Hospital Network Pressure Relief Technique and Spina Bifida fact sheet:
- The Sydney Children’s Hospital Network Foot care and Spina Bifida fact sheet http://www.schn.health.nsw.gov.au/fact-sheets/spina-bifida-foot-care
Remember:
- Prevention is better than cure, and most pressure injuries are preventable.
- A regular habit of checking skin morning and night is best practice.
