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What causes a pressure sore beneath the right ischia in a paraplegia patient?

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Posted on Mon, 23 May 2016
Question: I am a 45 year old t12 paraplegic (30 years) and have a pressure sore beneath my right ischia. It is 1 cm...but the skin around it is crackly and dry...looks dead. Is it?
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Answered by Dr. T Chandrakant (25 minutes later)
Brief Answer:
Please get early confirmation.

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Female/45 - paraplegia since 30 years - pressure sore beneath right ischia - 1 cm - skin around it is crackly and dry - looks dead - using Safegel and bandaging to keep moist - wants to know is it.
Dead skin has the following characters: loss of sensation, no bleeding on pin prick, looks black or white (blanched).
If these character are present it may be a dead skin patch
I would advise you to get this checked by a Doctor to get a confirmed diagnosis and go ahead as may be advised.
A second opinion of a plastic surgeon may be needed if further management is required.
Till then you may also apply liquid Povidone iodine to the whole area to keep it sterile, to avoid secondary infection as the skin around is cracked as per your history.
Use doughnut pillows for sitting purpose.
Take multivitamins as they do help a lot.
I am sure you must be using water bed or so.
Take care.
I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communications and please post photographs if possible.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. T Chandrakant (2 hours later)
Here is a picture
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Answered by Dr. T Chandrakant (13 minutes later)
Brief Answer:
As explained.

Detailed Answer:
Thanks for a very clear picture which shows a small wound that has blood at the base and there is a nearby area that has the dead skin, but it appears that this may be just superficial one.
as there is no reactionary changes around it.
The small ulcer has undergone the changes of chronic appearance and needs the proper care by removing a round layer of dead tissue that is not allowing it to heal.
Take the care as mentioned above.

Above answer was peer-reviewed by : Dr. Naveen Kumar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19417 Questions

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What causes a pressure sore beneath the right ischia in a paraplegia patient?

Brief Answer: Please get early confirmation. Detailed Answer: Hi. Thanks for your query. To recapitulate: Female/45 - paraplegia since 30 years - pressure sore beneath right ischia - 1 cm - skin around it is crackly and dry - looks dead - using Safegel and bandaging to keep moist - wants to know is it. Dead skin has the following characters: loss of sensation, no bleeding on pin prick, looks black or white (blanched). If these character are present it may be a dead skin patch I would advise you to get this checked by a Doctor to get a confirmed diagnosis and go ahead as may be advised. A second opinion of a plastic surgeon may be needed if further management is required. Till then you may also apply liquid Povidone iodine to the whole area to keep it sterile, to avoid secondary infection as the skin around is cracked as per your history. Use doughnut pillows for sitting purpose. Take multivitamins as they do help a lot. I am sure you must be using water bed or so. Take care. I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communications and please post photographs if possible.