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The Incidence of Skin Breakdown Associated With Use of Cervical Collars

Powers, Jan RN, MSN, CCRN, CCNS, CNRN, CWCN; Daniels, Dawn DNS, RN; McGuire, Carolyn RN; Hilbish, Chris RN, ACNP, CCRN, CNRN


ABSTRACT The most common adverse complication associated with cervical immobilization is skin breakdown. The purpose of this prospective, descriptive study was to assess the incidence of tissue breakdown associated with cervical immobilization. In this convenience sample of 484 patients, skin breakdown was noted in 33 (6.8%) patients. All cases of documented skin breakdown were stage I or II, with only 2 (0.4%) patients having stage III breakdown. Days in the cervical collar is a significant predictor of skin breakdown, along with presence of edema. Results from this study demonstrate that there is a very low incidence of complications of skin breakdown associated with the use of Aspen cervical collars. The collars are safe and effective to use in patients with actual or suspected head or spine injuries.

Jan Powers, RN, MSN, CCRN, CCNS, CNRN, CWCN, is Clinical Nurse Specialist, Critical Care and Neuroscience, and Carolyn McGuire, RN, is Staff Nurse, Neuro Critical Care, Clarian Health Partners, Methodist Hospital; Dawn Daniels, DNS, RN, is Clinical Nurse Specialist, Pediatric Trauma, and Program Coordinator, Injury Free Coalition for Kids of Indianapolis, Clarian Health Partners, Riley Hospital for Children; and Chris Hilbish, RN, ACNP, CCRN, CNRN, is Nurse Practitioner, Respiratory and Critical Care Consultants, Indianapolis, Ind.

Corresponding author: Jan Powers, RN, MSN, CCRN, CCNS, CNRN, CWCN, 6320 Keeneland Court, Indianapolis, IN 46278 (e-mail:

Copyright © 2006 by the Society of Trauma Nurses.