Use of alternatives to air-fluidized support surfaces in the care of complex wounds in postflap and postgraft patients.

Air-fluidized support surface therapy has many drawbacks, such as dehydration, in an already difficult recovery for those wound patients who have undergone flap and graft surgery. In addition, patient care and handling are also problematic. Patients complain of discomfort, and the instability of the surface interferes with patient stability in side lying and semi-Fowler's positions.

Collagen injections for intrinsic sphincter deficiency in the neuropathic urethra.

Twelve subjects experiencing stress urinary incontinence caused by spinal injury or myelomeningocele were treated by periurethral injection of a bulking agent, glutaraldehyde cross-linked (GAX) collagen. Of the 11 subjects who completed the program, seven were either cured or improved and four were only slightly improved or no better following injection. The valsalva (abdominal) leak point pressure (LPP) rose an average of 57 cm H2O (pre-treatment mean of 60 cm H2O versus post-treatment mean of 117 cm H2O) and none of the patients experienced significant complications during the mean follow-up period of 24 months.

Spinal cord injury in youth.

To identify special characteristics of the pediatric spinal cord-injured (SCI) population, we analyzed a database of 1,770 traumatic SCI patients; 88 (5%) fell into the two pediatric subgroups: 0-12 years (n = 26) and 13-15 years (n = 62) at time of injury. Differences between age groups were identified with regard to demographics, neurologic characteristics, associated injuries and complications, and management. Mode level of bony injury was C2 in preteens, C4 in teens, and C4-C5 in adults.

Social support and health status in spinal cord injury.

In a mailed survey, 125 persons with spinal cord injury responded to questions on the SCI Quality of Life Index (QOLI), and the Reciprocal Social Support Scale. The results indicated that people with SCI who believe that they receive support from the community, compared to those who believed they received less support (1) perceived themselves to be better adjusted to their injury, and (2) had significantly fewer health problems (fewer spinal cysts, lower blood pressure, shorter recovery time from decubitus ulcers, less pain below the level of injury, and fewer hospital admissions). The results also showed that people who believe that they contribute to the community in some way, compared to those who believed they contributed little or nothing (1) perceived themselves to be better adjusted to their injury, and (2) had significantly fewer health problems (fewer urinary tract infections, fewer decubitus ulcers, less severe decubiti, less pain above the level of injury, and fewer hospital admissions).

The value of urodynamics and bladder management in predicting upper urinary tract complications in male spinal cord injury patients.

A review of 160 male patients admitted to the Shepherd Spinal Center was completed to determine the influence of urodynamic findings and choice of bladder management program on the risk of developing upper urinary tract distress following acute spinal injury. Within the context of this investigation, upper urinary tract distress was defined as presence of hydronephrosis, febrile urinary tract infection, urolithasis or vesicoureteral reflux. Three groups were identified according to the urodynamic findings and the bladder management program.

Mortality after spinal cord injury: a four-year prospective study.

Research has suggested that mortality after spinal cord injury (SCI) is correlated with lower levels of social and vocational activities and lower life satisfaction. The purpose of this study was to use prospective data from a 1985 SCI follow-up study to identify predictors of survival status four years later. In 1985, responses to the revised Life Situation Questionnaire were obtained from 347 participants with SCI.

Employment after spinal cord injury.

The purpose of this study was to compare preinjury and postinjury employment rates in a diverse sample of persons with spinal cord injuries. Several employment variables were compared in individuals grouped into cohorts based on injury level, chronologic age, age at injury, time since injury, and years of education. The study sample (N = 286) was highly educated (mean = 14.

Technology in the Management of Spinal Cord Injuries.

Injury to the spinal cord is catastrophic and usually permanent. Whereas other injured tissues, such as bone, skin, blood vessels and peripheral nerves, are capable of being repaired and resuming near normal function, such is not the case with the spinal cord. Thus far, all attempts to repair the cord using every conceivable technique has ended in failure.

Chronologic age, time since injury, and time of measurement: effect on adjustment after spinal cord injury.

People are now living longer after spinal cord injury (SCI), yet only limited research has addressed the issue of aging and adjustment after SCI. The purpose of this study was to use a time-sequential design to identify the relationship between adjustment after SCI and three facets of aging; chronologic age, time since injury, and time of measurement. Life Situation Questionnaires were obtained from one sample of participants with SCI in 1974 (n = 256) and from a second sample in 1985 (n = 193).

Facilitating and assessing progress toward independence: SPARX.

As children with spina bifida are thriving physically, a need for encouraging independent behavior has arisen. The dynamics of dependency undermine youngster's potential for autonomous functioning. As programs are being developed, there is a need to measure the dimensions which contribute to independent behavior.