As a general rule, if a child has some loss of movement, there will be loss of skin sensation too.

For example, a child who has no movement from mid-trunk level, will generally have no feeling from that level downwards. He cannot feel anything inside (e.g. the need to go to the toilet) or outside (e.g. when something touches his leg).

For lower lesions, it is not so straightforward. A child may be able to walk fairly well, seem only to lack some movement in the foot, but loss of sensation will usually be in some areas of feet, right up the leg, and also the buttocks.

• 1. BURNS
• 
  Examples:
  • 
  • Sunburn on legs/feet (especially if shoes/socks are usually worn).
  • Wheelchair left in hot sun. Child transferring back into a hot wheelchair may burn buttocks, legs and feet.
  • Hot drinks/chips held on lap.
  • Hot car/bus seat

    N.B. Because of poor circulation and poor nerve supply, the skin is often not strong and will burn more easily than normal.

    How to Prevent:

  • Wear shoes/socks }
  • Wear long pants } where practical
  • Awareness! by child and carers.
  • Check for hot surfaces
• 2. SCRAPES
• 
  Examples
  • Child crawling on rough ground (especially pool surrounds) may scrape knees, ankles and toes.
  • During transfers from floor to wheelchair, child may scrape body and legs on footplates.
  • During transfers from wheelchair to chair, child may scrape buttocks (this can be a big problem if it happens repeatedly).

    N.B. Any scrape/scratch may take longer to heal than in another child.

    How to Prevent

  • Wear shoes and socks )
  • Wear long pants ) where practical
  • Wear knee pads )
  • Good transferring techniques.
  • Awareness! by child and carers.

  
  
  
  
  
  



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Typical areas are:

• Buttocks/sacrum from prolonged sitting in wheelchair.
• Heels/ankles from ill-fitting or incorrectly applied splints.

These can develop into very nasty sores, if not treated early and effectively. They can in some cases, take months or years to heal. Treatment must involve removing the pressure.

How to Prevent:

• Regular bottom lifts for wheelchair users.
• Sheepskin or pressure-relief cushion on wheelchair.
• Care with surface that a child is sitting on, and nothing in back pockets of pants, etc.
• Regular checking of heels/ankles, etc. for red areas from splints.
• Beware of problems like sand getting into splints - (abrasive effect).