Pressure ulcer stage IV caused by cervical collar in patients with multiple trauma in intensive care unit.

Dear Editors, Cervical collars are necessary to immobilise the cervical spine of patients with multiple trauma (1,2). This devise remains in situ until the radiographic cervical spine clearance is completed (2). A 29-year-old male with multiple trauma and subdural haemorrhage admitted to the intensive care unit (ICU) was selected for this case study. The patient had been taken to hospital by emergency medical service (EMS) following an accident. He was fitted with a Philadelphia rigid collar at the site of the accident by EMS technicians. After admission to the hospital and assessment by emergency physicians, neurosurgeons and orthopaedic surgeons, he was transferred to the ICU. Five days later, the spinal clearance process was completed. On day 6 after ICU admission, physicians ordered removal of the cervical collar. After removal of the collar by critical care nurses, two stage IV pressure ulcers were observed. One ulcer developed in his occiput and the other on his chin (Figures 1 and 2).