Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - 82

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PRESSURE ULCER PREVENTION AND TREATMENT FOLLOWING SPINAL CORD INJURY

Glossary
amyloidosis: a disease characterized by extracellular
accumulation of amyloid in various organs and tissues; may
be primary or secondary
autonomic dysreflexia: also known as hyperreflexia, an
uninhibited sympathetic nervous response to a variety of
noxious stimuli occurring in individuals with spinal cord
injury at the thoracic 6 (T-6) level and above.
closed ulcers: a full-thickness wound that has closed by
secondary intention.
collagen type VII biosynthesis: the formation, by the
cells, of type VII collagen, which is found principally in
basement membrane and anchoring fibrils of the epithelium.
cytokine-induced inflammatory state: an injury,
infection, or wound, such as a pressure ulcer, that results in
the release of cytokines by cells. Cytokines activate the
systemic inflammatory state, characterized by specific
changes in nutrient metabolism, nutrient requirements, and
body composition.
debridement: excision of devitalized tissue and foreign
matter from a wound.
Doppler fluxmetry: a method of measuring the flow of
liquids in tissue with blood cells reflecting sound waves,
used in measuring velocity of flow.
electrical stimulation: a modality that delivers a
therapeutic dosage of electrical charge (200-800
microcoulombs) to wound tissues to accelerate closure
of the wound.
enteral nutrition: the provision of nutrients via the
gastrointestinal tract. Oral enteral nutrition is taken through
the mouth; tube interal nutrition is the delivery of nutrients
directly through a tube inserted into the stomach,
duodenum, or jejunum.
epithelialization: formation of epithelium over a denuded
tissue surface.
evidence-based guidelines: clinical practice guidelines
that have been developed using research findings that have
been graded for scientific strength.
exudate: any fluid that passes out of a body structure or
tissues because of injury or inflammation.
grading of evidence: a standardized method for evaluating
the strength of research literature used in development of a
clinical practice guideline or other evidence-based
document.
granulation: the formation of minute, rounded, fleshy
connective tissue projections and capillary buds on the
surface of a wound, ulcer, or inflamed tissue surface in the
process of healing.
heterotopic ossification: abnormal bone formation in soft
tissue; common locations include the hip and/or knee, which
can restrict flexion to less than 90%.
hydrocolloid occlusive dressing: a wound dressing
consisting of absorbent sodium carboxymethylcellulose,
pectin, gelatin, and elestomer held in a fine suspension on a
polyurethane foam or film backing using to hermetically
seal a wound.

hydroxylation: placing of a hydroxyl group on a
compound in a position where one did not exist previously.
hyperchloremic acidosis: an abnormal amount of
chloride ions in circulating blood or tissue.
hypergranulation: excessive growth of granulation tissue
above the cutaneous border of a wound that heals by
secondary intention.
hyperreflexia-See autonomic dysreflexia
hypoalbuminemia: the below-normal concentration of
albumin in the blood.
lymphopenia: a reduction in the number of lymphocytes in
the circulating blood.
Marjolin's ulcer: an aggressive, well-differentiated
squamous cell carcinoma, occurring in cicatrical tissue at
the epidermal edge of a sinus draining underlying
osteomyelitis.
methodology team: a group (usually university-based)
who performs literature reviews, grades the evidence, and
completes specialized studies in support of evidence-based
clinical practice guideline development.
micronutrients: vitamins, minerals, and trace elements.
necrosis: pathologic death of cells, or a portion of tissue or
organ, resulting from irreversible damage.
nonblanchable erythema: redness of the skin that
persists when fingertip pressure is applied; a symptom
of a stage I pressure ulcer.
paraplegia: impairment or loss of motor and/or sensory
function in the lower extremities due to damage of the
neural elements within the thoracic, lumbar, or sacral
segments of the spinal cord.
parenteral feedings: the provision of nutrients
intravenously. Peripheral parenteral nutrition is delivered
through small peripheral veins; central or total parenteral
nutrition is delivered through a large central vein, usually
the superior vena cava.
periulcer maceration: maceration of the skin surrounding
the ulcer.
poiklothermia: capable of existence and growth in
mediums of varying temperatures.
sinus tracts: blind ending tracts that open onto the
epithelial surface; may indicate presence of a foreign body
or abscess located in the deep tissues.
tetraplegia: impairment or loss of motor and/or sensory
function in all four extremities due to damage of the neural
elements within the cervical segments of the spinal cord.
transcutaneous oxygen tension: the partial pressure of
oxygen in tissue beneath the skin.
undermining: a measurable opening in the sidewall of a
full-thickness wound, beginning at the wound edge, running
beneath the skin, and either parallel or tangential to the skin
surface for a variable distance.
wound dehiscence: a bursting open, splitting, or gaping
along natural or sutured lines.
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury

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