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Pressure causing dry skin ?

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    Pressure causing dry skin ?

    I suffer with constant pressure sores on my right ischial and have just got back to being up all day. Ischial had healed nicely with normal pink tissue. Just over a week ago we noticed that he skin looked dry, tried using a skin moisturiser but next day it was slightly whiter, this went on until the weekend when the top layer of skin was like a crust and the edges peeling away from the healthy skin underneath with small breaks around the edge. I'm back in bed again as we try and get the crust to peel away hopefully leaving healthy skin.

    Need to avoid this happening in the future but it is a difficult balance between keeping skin moist but not too moist and also wondering whether being sat up all day could cause the drying. Has anyone else had skin dry out then form a crust? Was it pressure related? And how did you look after the skin once it healed?

    #2
    I get some dry, slightly scaly area in the gluteal cleavage, which I've concluded is chafing from my pantie pads. It's bee like that for over a tear now and I conclude it is not dangerous. I use a facial cleaning product that removes dry skin once a week so it does not develop cracks, then put a greasy protective stuff on it after showers. This sounds different from your problem and I've never had a sore.

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      #3
      Any pant seams rubbing on the area?
      any new detergents?
      Is the fabric shearing on your skin, with lots of moving around in the seat?

      you may have an unbalanced pelvis with that ischial bone more prominent when sitting?
      have you had seat mapping?

      pbr
      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

      Comment


        #4
        Originally posted by SCI-Nurse View Post
        Any pant seams rubbing on the area?
        any new detergents?
        Is the fabric shearing on your skin, with lots of moving around in the seat?

        you may have an unbalanced pelvis with that ischial bone more prominent when sitting?
        have you had seat mapping?

        pbr
        The only change is stopping using my FES bike as I move in the seat, we thought that it caused shearing. Probably about 6 weeks ago I stopped. Last pressure map was even left/right with low pressure all over the cushion. Could pressure from being sat up all day cause it to dry out?

        Comment


          #5
          I’m not exactly sure what is occurring from your description. Do you perspire while sitting all day? Any history of abscesses or skin pores that have become irritated?
          You may need to have it examined and pressures re-evaluated
          This is a tough one
          pbr
          Last edited by SCI-Nurse; 8 Feb 2019, 11:51 PM.
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment


            #6
            This used to happen to me frequently in the same area you're describing. My skin would randomly appear dry for no obvious reason. I could go months without a problem and it would pop up out of nowhere. The wound doctor always blamed pressure, but I think it was sweat accumulating in the area. I had used a Roho cushion for years, but about 6 months ago, I switched to a Ride Java cushion with the ischium area completely cut out. Since then, my skin hasn't had the slightest irritation. I don't know if it's because of the pressure reduction or the improved air circulation in the area, but this cushion is the best thing to happen to me in the 17 years I've been injured.
            Chuck Norris doesn't go hunting because the term hunting implies a chance of failure. Chuck Norris goes killing.

            Comment


              #7
              I get dry skin on high pressure areas.

              Comment


                #8
                I don't sweat and the dry area is over a former pressure sore so skin is damaged. In the photo the white area is dry and like a crust, it has receded at the sides breaking the good skin. The white skin almost lifts at the edges as though it wants to come off. I've been in bed the last week and it has reduced.
                Attached Files

                Comment


                  #9
                  This could be the result of a skin pore being irritated or sheared while sitting -folliculitis or a contact dermatitis
                  dermatologists will recommend daily washing with soap and water and air drying as a first step
                  that crust is probably not dry skin it could be drainage
                  https://www.mayoclinic.org/diseases-...s/syc-20361634

                  this article may not resonate completely with your situation

                  you may need to keep the area covered with a duoderm or foam dressing to prevent shearing of the skin

                  get it checked out as it could lead into an abscess

                  pbr
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                  Comment


                    #10
                    We have been cleaning it with warm water carefully to avoid any more coming away. Originally it was a sore we think caused by shearing whilst using my FES bike but we thought that we were taking a lot more care to avoid shearing, maybe not. It is covered with a tegaderm foam dressing at the moment and my district nurse visits regularly to check it but they weren't sure what had caused the dryness and crust, I'll see them on Monday. My big concern is that it is pressure related, I can't face reducing the hours I am up.

                    Comment


                      #11
                      Well, it looks like it was a mess under it. I had to be in the chair for a long time Friday whilst evacuated to my local hospital due to the risk of flooding, returned yesterday and up for a good few hours. Honey and tegaderm foam removed to find this. It looks like either a lot of bed rest or just get on doing things until it breaks down and then switch the vent off. Tired of trying to lead any kind of live and living most of it in bed.
                      Attached Files

                      Comment


                        #12
                        From your post I assume that you got treatment started
                        I hope the treatment heals it quickly

                        pbr
                        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                        Comment


                          #13
                          Originally posted by SCI-Nurse View Post
                          From your post I assume that you got treatment started
                          I hope the treatment heals it quickly

                          pbr
                          My district nurse team is as confused as me as to how it went from a dry skin layer to grade 2 sore in 1 day. We are using a honey dressing and tegaderm foam dressing to remove the slough initially. Checking every 3 or 4 days. I'm in bed sat up working with a pillow wedged under that cheek, there is pressure on it but I can't find another way to work.

                          Comment


                            #14
                            Originally posted by mrb View Post
                            My district nurse team is as confused as me as to how it went from a dry skin layer to grade 2 sore in 1 day. We are using a honey dressing and tegaderm foam dressing to remove the slough initially. Checking every 3 or 4 days. I'm in bed sat up working with a pillow wedged under that cheek, there is pressure on it but I can't find another way to work.
                            I have a memory foam topper which I cut a hole in for the most sensitive part of my anatomy. The challenge is getting my gimpy ass in the right spot.

                            Comment


                              #15
                              Was it actually dry skin, or more like a callous? The latter can be confused with hyperkeratosis, which is a callous like area that can cover an underlying deeper pressure ulcer, or line the edge of a pressure ulcer. It must be removed (debrided) for the wound to resume healing, as its presence prevents the growth of normal fibroblasts.

                              Also, the wound pictured above is not a stage II. Since it is covered with eschar, it should be called "unable to stage" (UTS), until the eschar is debrided, and then may actually be deeper.

                              (KLD)
                              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                              Comment

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