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Original article
Recent skin injuries in children with motor disabilities
  1. Christopher John Newman1,
  2. Cécile Holenweg-Gross1,
  3. Carole Vuillerot2,
  4. Pierre-Yves Jeannet1,
  5. Eliane Roulet-Perez1
  1. 1Paediatric Neurology and Neurorehabilitation Unit, University Hospital Lausanne, Lausanne, Switzerland
  2. 2Paediatric Rehabilitation Centre, L’Escale, University Hospital Lyon-Sud, Lyon, France
  1. Correspondence to Dr Christopher Newman, Paediatric Neurology and Neurorehabilitation Unit, Hospital Nestlé – CHUV, Avenue Pierre Decker 5, 1011 Lausanne, Switzerland; christopher.newman{at}chuv.ch

Abstract

Objective To determine the frequency of recent skin injuries in children with neuromotor disabilities and its association with disability.

Design Cross-sectional study of 168 children with neuromotor disabilities aged 2–16 years.

Setting Two outpatient child rehabilitation centres.

Main outcome measures Children were classified as unrestricted walkers, restricted walkers or wheelchair dependent. Each participant's body surface was systematically examined for recent skin injuries with the exception of the anal-genital area.

Results The mean age of our sample was 7.8 (SD 3.7) years with a 3:2 male/female ratio. Overall, 64% had cerebral palsy, 17% a neuromuscular disease and 19% other motor disabilities. Participants had on average 5.3 (SD 4.5) recent skin injuries (max 19), of which 2.5 were bruises (SD 3.3, max 16), 2.4 were abrasions, scratches or cuts (SD 3.0, max 16) and 0.4 were pressure lesions (SD 0.8, max 4). There was a significant decrease in the frequency of recent skin injuries and of bruises with increasing severity of motor disability. Most of this variation was accounted for by injuries to the lower limbs. There were no significant effects of gender, learning disabilities or other comorbidities.

Conclusions Children with neuromotor disabilities present a progressive reduction in the number of skin injuries with decreasing mobility. Therefore, recent skin injuries in this population which are unusual by their number, appearance or distribution, should raise at least the same level of suspicion for physical abuse as in children without disabilities.

https://doi.org/10.1136/adc.2009.163691

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    Footnotes

    • Funding Anna Müller Grocholski Foundation, Zürich, Switzerland generously supported this research.

    • Competing interests None.

    • Patient consent Parental consent obtained.

    • Ethics approval This study was conducted with the approval of the Commission d’Ethique, Faculté de Biologie et Médecine, Lausanne University.

    • Provenance and peer review Not commissioned; externally peer reviewed.