Spinal Cord Injury

SCI: Pressure Ulcers (2007)

• Assessment
  What is the role of nutritional status and nutrition care in the prevention of pressure ulcers in Spinal Cord Injury patients?

  • Conclusion

    The clinical practice guidelines regarding the prevention and treatment of pressure ulcers developed by the Consortium of Spinal Cord Medicine, based on the scientific literature published from 1966 - 1998, suggest regular assessment of nutritional status with attention to risk factors associated with the development of pressure ulcers, the provision of adequate nutritional intake, and the implementation of aggressive nutritional support measures if indicated.  Three studies, which have been published since that time, reported associations between reduced pressure ulcer development and higher levels of serum total protein, albumin, prealbumin, zinc, and vitamin A.  In addition, two studies reported that pressure ulcer development was least likely to occur among spinal cord-injured individuals who maintained a normal weight and demonstrated other protective behaviors related to diet, exercise and lifestyle.      

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the role of nutritional status and nutrition care in the prevention of pressure ulcers in SCI?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Consortium for Spinal Cord Medicine Clinical Practice Guidelines. Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury: A Clinical Practice Guideline for Health-Care Professionals. J Spinal Cord Med 2001;24 Suppl 1:S40 - S101.
      • Cruse JM, Lewis RE, Roe DL, Dilioglou S, Blaine MC, Wallace WF, Chen RS. Facilitation of immune function, healing of pressure ulcers, and nutritional status in spinal cord injury patients. Experimental and Molecular Pathology 1999;68:38-54.
      • Goodman CM, Cohen V, Armenta A, Thornby J, Netscher DT. Evaluation of results  and treatment variables for pressure ulcers in 48 veteran spinal cord-injured patients. Ann Plast Surg 1999;42:665-672.
      • Krause JS, Broderick L. Patterns of recurrent pressure ulcers after spinal cord injury: identification of risk and protective factors 5 or more years after onset.  Arch Phys Med Rehabil. 2004;85:1257-1264.
      • Krause JS, Vines CL, Farley TL, Sniezek J, Coker J.  An exploratory study of pressure ulcers after spinal cord injury: realtionship to protective behaviors and risk factors. Arch Phys Med Rehabil 2001;82:107-113.
      • Moussavi RM, Garza HM, Eisele SG, Rodriguez G, Rintala DH. Serum levels of vitamins A, C, and E in persons with chronic spinal cord injury living in the community. Arch Phys Med Rehabil 2003;84:1061-1067.
  • Search Plan and Results: Pressure Ulcers 2006