Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 2 - MANAGEMENT OF SCI COMPLICATIONS

S - SKIN INTEGRITY




Consider the use of an occlusive hydrocolloid dressing, instead of cream or dressing, for the healing of stage I and II pressure injuries. (CAN-SCIP 2020; Level A)
Consider the use of topical phenytoin for the healing of stage I and II pressure injuries post-SCI. (CAN-SCIP 2020; Level A)
Consider using Medihoney to improve the healing rate and residual soft, elastic scars in persistent stage III and IV pressure injuries in individuals with SCI. (CAN-SCIP 2020; Level C)

Assemble an interprofessional team to ensure optimal management of the individual and the pressure injury before, during, and after surgery, including:

  1. selecting appropriate surgical candidates
  2. performing a comprehensive assessment
  3. implementing appropriate preoperative management
  4. selecting the best surgical option and implementing it with expertise
  5. planning and implementing optimal postoperative care.
(Adapted from PU-ONF 2013, p.175; Level C)
Refer appropriate individuals with complex, deep, stage III pressure injury, which may include pressure injuries with undermining or sinus tracts and those with stage IV pressure injury for surgical evaluation. (Adapted from PU-ONF 2013, p.175; Level B)
Involve a registered dietitian to assess nutritional status and correct preoperatively nutritional imbalances that are anticipated to have a significant effect on the success of surgical repair. (PU-ONF 2013, p.177; Level B)

Know and implement appropriate postoperative care after all pressure injury surgical repair:

  1. assess and manage pain
  2. evaluate support surfaces
  3. position the individual to keep pressure off the surgical site
  4. consider using an active bed surface when pressure on the surgical flap is unavoidable
  5. consider using a Clinitron® air fluidized therapy bed after surgery
  6. arrange a seating and postural assessment at the appropriate time during the postoperative mobilization period
  7. progressively and gradually mobilize the individual to a sitting position over at least 4 to 8 weeks to prevent re-injury of the pressure injury or surgical site
  8. provide education on pressure management and skin inspection.
(Adapted from PU-ONF 2013, p.184; Level C)