Rathore Farooq A, New P W, Waheed Akhtar
Spinal Rehabilitation Unit, AF Institute of Rehabilitation Medicine, Rawalpindi, Pakistan.
Am J Phys Med Rehabil. 2009 Jul;88(7):587-90. doi: 10.1097/PHM.0b013e318198b6d7.
Case series of pressure ulcers in patients with spinal cord injury after inappropriate and prolonged application of graduated compression stockings are presented. Three adult patients with spinal cord injury were fitted with graduated compression stockings in the acute phase to prevent thromboembolism. Acute hospital staff did not monitor the skin for potential pressure ulcer because of the graduated compression stockings. Grade II pressure ulcers developed on the toes in all three cases. All pressure ulcers were managed conservatively and healed without complication. The manufacturers of graduated compression stockings did not include information about the need to monitor patients with sensory impairment for pressure ulcers. It is suggested that the manufacturers of graduated compression stockings include information about the need to monitor patients with sensory impairment for skin breakdown. When graduated compression stockings are applied to patients with sensory impairment, including spinal cord injury, staff needs to be vigilant for pressure ulcers occurring at the extremes of the graduated compression stockings, in addition to the more common areas where pressure ulcers occur.
本文介绍了脊髓损伤患者在不恰当且长时间使用梯度压力弹力袜后发生压疮的病例系列。三名成年脊髓损伤患者在急性期使用梯度压力弹力袜以预防血栓栓塞。由于使用了梯度压力弹力袜，急性医院工作人员未对皮肤进行潜在压疮监测。所有三例患者的脚趾均出现了Ⅱ级压疮。所有压疮均采用保守治疗且愈合，无并发症。梯度压力弹力袜制造商未提供有关监测感觉障碍患者压疮的必要性的信息。建议梯度压力弹力袜制造商纳入有关监测感觉障碍患者皮肤破损的必要性的信息。当梯度压力弹力袜应用于包括脊髓损伤在内的感觉障碍患者时，工作人员除了要警惕压疮更常见发生部位外，还需对梯度压力弹力袜末端发生压疮保持警惕。
