Pediatric patients at risk include:
(1) myelodysplasia (developmental abnormality of the spinal cord such as spina bifida occulta)
(2) cerebral palsy
(3) clubfeet
(4) scoliosis
(5) other
Risk factors for pressure ulceration:
(1) paralysis
(2) immobility
(3) insensate areas (unable to recognize an early injury)
(4) high activity (increased likelihood of trauma or friction)
Skin trauma:
(1) friction
(2) foreign debris rubbing skin
(3) chemical or thermal burns
(4) trying to scratch skin covered by a cast or appliance
(5) walking barefoot or with areas of exposed skin
Problem with orthopedic device:
(1) poorly fit
(2) improperly worn
(3) failure to change as the child grows
Moisture causing skin maceration:
(1) perspiration
(2) swimming or bathing with cast
(3) incontinence
Preventive measures:
(1) instruct the caregivers and patient to regularly inspect skin and problem areas for signs of skin damage or breakdown
(2) wear protective clothing and shoes to reduce environmental injuries
(3) keep areas dry and free of foreign debris
(4) maintain proper nutrition
(5) wear the orthopedic device properly and make adjustments as the child grows
