Decubitus bij dwarslaesiepatiƫnten: proactief inspecteren

Klinische les
Elise J. Huijssen-Huisman, Tebbe A.R. Sluis en Henk den Besten

Decubitus ulcers in spinal cord lesion: proactive inspection

Two patients, a 23-year-old and a 70-year-old man, were admitted to a hospital with a spinal cord lesion. During their stay they developed severe decubitus ulcers which was not noticed until after they were moved to our rehabilitation centre. Despite conventional wound therapy one of the two patients developed an infection deriving from the necrotic decubitus wound which resulted in severe sepsis. A necrotomy had been delayed because of the medical history of this patient and because of the waiting list. These cases show that all parties involved with patients with spinal cord lesions should be aware of the high risk of decubitus ulcers. Frequent skin checks of the sites at risk by both carer and patient are necessary, and early necrotomy is important for the adequate treatment of decubitus.