Risk factors for pressure sores in adult patients with myelomeningocele--a questionnaire-based study.

Pål-Erik Plaum,Kathrine Frey Frøslie,Gunnar Riemer

doi:10.1186/1743-8454-3-14

Pål-Erik Plaum, Kathrine Frey Frøslie + Show 1 more

Open Access

https://doi.org/10.1186/1743-8454-3-14

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Abstract

BackgroundMyelomeningocele (MMC) is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system. Pressure sores are a frequent complication for patients with MMC. Little is known about the risk factors for pressure sores in adults with MMC. The aim of this study was to investigate an association between the presence of pressure sores and other patient characteristics, in order to develop an improved strategy for the management of sores.MethodsA structured questionnaire regarding sores, medical condition, function and living factors was designed and sent to the 193 patients with MMC registered in the year 2003 at TRS, a National Centre for Rare Disorders in Norway.ResultsOut of 193 total, 87 patients participated and 71 patients (82%) reported sores; 26 (30%) at the time of the interview and 45 (52%) during the last 5 years. Sores were mostly localized on toes and feet and occurred exclusively in regions with reduced or missing sensibility. A significant association was found between sores and memory deficit (p = 0.02), Arnold Chiari malformation (p = 0.02) and a record of previous sores (p = 0.004). Sores were not significantly associated with hydrocephalus, syringomyelia, nutrition, body mass index, smoking, physical activity, employment or living together with other persons. Some patients (18, 21%) reported skin inspection by others and the remainder relied on self-inspection.ConclusionPatients with sensory deficit, memory problems, and Arnold Chiari malformation had a higher risk of having pressure sores. This patient group needs improved skin inspection routines and sore treatment.

Highlights

Myelomeningocele (MMC) is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system
Myelomeningocele (MMC) is a complex congenital spinal anomaly that causes varying degrees of spinal cord malformation, or myelodysplasia. It is a developmental defect in the formation of the neural tube from the embryonic neural plate, and as such is a disorder of the cerebrospinal fluid system
The association of sore prevalence with sensory deficit as a risk factor for sores is in accordance with other studies

Summary

Introduction

Myelomeningocele (MMC) is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system. Pressure sores are a frequent complication for patients with MMC. Myelomeningocele (MMC) is a complex congenital spinal anomaly that causes varying degrees of spinal cord malformation, or myelodysplasia. It is a developmental defect in the formation of the neural tube from the embryonic neural plate, and as such is a disorder of the cerebrospinal fluid system. In this paper we use the term MMC, because it focuses on the neurological structures. MMC is often associated with tethered cord and an abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. Hydrocephalus is the most common (page number not for citation purposes)

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