Tomato to Eggplant

As someone living with paralysis, wound prevention is very important. In almost 3 years of being a paraplegic, I’ve only acquired 1 small stage 2 pressure injury on my bottom that quickly healed. Thankfully it didn’t turn into something that would cause me to be on bed rest for a couple of weeks.

There are 4 stages of pressure injuries: an unstageable pressure injury and a Deep Tissue Injury (DTI). I like to think of Stage 1 as non-blanching redness like a tomato, and Stage 4 as full-thickness tissue loss, and the core is exposed. And then there is the unstageable, which is full-thickness skin/tissue loss, but we cannot see underneath “rotten” parts.

Once we have DTI, an area that may be boggy, firm or feel “different” than the surrounding skin and can have a blood blister. With a DTI, it’s a dark purple/maroon in color, like an eggplant.

In the medical world, we use the Braden Scale, a scale that is used for predicting pressure injury risk. But with this scale, when eschar is present, a pressure injury cannot be accurately staged until the eschar is removed. An eschar is dead tissue that eventually sloughs off healthy skin after an injury. To determine the risk of developing a pressure injury, 6 things are considered, and with each one, there is a score for that category.

1) Sensory Perception- the ability to respond meaningfully to pressure-related discomfort.

2) Moisture – the degree to which skin is exposed to moisture.

3) Activity – degree of physical activity.

4) Mobility - ability to change and control body position.

5) Nutrition- usual food intake pattern.

6) Friction and Shear. Each section tallies up to a score. Once added all together, a patient with a score of 18 or less is considered at risk of developing pressure injuries.

As a person who can’t stand on their own anymore, how do you prevent getting pressure sores? Avoiding hot water, and other hazards are a start. Next, being active. Just move some if you can, and if you can’t, have someone help you. Checking your body regularly for sores is a must. You must know your body and how it reacts to different sitting positions. Eating a healthy diet and losing weight go hand in hand with me. It's so easy to gain weight in a wheelchair and even harder to lose it. Some medicines that you take can all contribute to your weight gain. So, talk to your doctor about your medications. Managing your health conditions and Practicing healthy hygiene habits and skincare is extremely important.

Pressure injuries are to acquire but a nuisance to get rid of. In the past, when I had one, I cleared it up in 3 days using 2 simple things. Coating your sore with a protective barrier cream or ointment is highly recommended. First, I used Aquaphor Healing Baby Ointment. I used the ointment in the morning before going to work. My job requires me to be in my chair at least 12.5 hours a day, 2-3 times a week, maybe more. That’s just my work hours and not my prep or bedtime routine.

The number one thing for being in my chair that long is relieving pressure off my bottom by shifting my position. At night I would use this natural healing salve made locally here in Kansas City. Those combinations and drinking more water plus sleeping on my side bare so I could “air out” I was healed in 2.5-3 days with a stage 2 pressure injury. I hope this information from an average Joe helps someone.

Remember, your health is wealth, and never be scared to advocate for yourself.

Resources:

Adventishealthcare.com/services/wound-care/prevention

North Kansas City Hospital Pressure Injury Staging poster

Braden Scale information card

Gigisnaturalhippiessentials.com (natural salve)