stressorsApproximately 85% of Spinal Cord Injury sufferers (SCI) relying on wheelchairs, counting over 380.000 in Europe and with over 11.000 new cases each year will develop Pressure Ulcers (PU) during their lifetime.

Between one third and a half of all SCI sufferers will develop a PU in the first five years of their trauma and 7-8% will eventually die of complications. On the other hand, direct costs involved treating PUs in SCI sufferers exceed €2 Billion per year, counting up for 10% of the total costs involved treating PUs.

Decubitus ulcers, ischemic ulcers, bedsores or most commonly known as pressure ulcers (PU) are localized injuries in the skin and/ or underlying tissue initiated by a sustained impaired blood flow. As tissue cells depend on oxygen and nutrients transported by the blood flow, after a prolonged period these will lack (ischemia situation) and cells will die (necrosis), starting the process of ulceration.

Moreover, an inverse relation between tissue viability and the presence of key stressors intensifies the process of ulceration, affected tissue viability requires a lower pressure to occlude blood flow.

        pressure ulcers

PU development in 4 stages:
From left stage 1 (non-blanchable redness) to right stage 4 (Full thickness tissue
loss with exposed bone)


Suffering a PU leads to the following negative impacts:

a)Deterioration of health, as the presence of a PU may worsen the underlying clinical situation of the patient (need of additional surgical interventions or longer recovery times) and constituting even a deadly threat due to infections.

b)Social exclusion, the pain and odour caused by the chronic skin ulcer stigmatizes the people, leading to depression and social isolation.

c)Reduction of independent living, reducing the time a person can spend safely in a wheelchair limiting their activities of the daily living and affecting to their jobs.

This situation leads to a decrease of the overall healthrelated quality of life, while treating PUs results in a significant cost for the European Public Health System estimated at €20 billion per year.