Pressure Sore Risk Management in Children with Cerebral Palsy: Local and Whole Body Thermoregulation Strategies, Material Interface and Care Protocols

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Pressure sores in wheelchair-bound patients are painful, may cause serious infections, impair quality of life for children and their families, and are expensive to the health-care system (Pham et al. 2011). Children with cerebral palsy (CP) have relatively high metabolic rates due to muscle spasticity. This, combined with being wheelchair-bound for all or most of the day and with a reduced skin surface area available for sweat evaporation (Moreau et al. 2002, Majd et al. 1997), escalates skin maceration (wetness) and increases the risks for pressure sores (McCaskey & Gerdes, 2011; Johnson et al. 1995). Presently, no accepted care protocols exist aimed at reducing skin maceration and the concomitant risk of pressure sores among wheelchair-bound children with CP. This project will examine the factors putting wheelchair-bound children with CP at risk for pressure sores. Factors such as CP-specific temperature regulation challenges, wheelchair-seat interfaces and seat technologies, along with appropriate care protocols will be studied to determine how they contribute to the development of pressure sores in this vulnerable population. The results will lead to novel and innovative interface technologies (i.e., body-seat interface application); They will also inform guidelines for health-care providers, physiotherapists, coaches, teachers and parents, aimed at reducing the risk of pressure sores in children with CP and other wheelchair-bound populations. By reducing the risk of pressure sores, families impacted by CP will be better able to manage the care of their children, lessen the adverse effects of the disability and attain a vastly improved quality of life for the children and their families.