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Introduction

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Pressure ulcers are a serious, lifelong secondary complication of spinal cord injury (SCI) that have the potential to “interfere with physical, psychological and social well-being and to impact overall quality of life” (Consortium for Spinal Cord Medicine 2000, p. 9). Although preventable in most situations, when they occur, pressure ulcers may “disrupt rehabilitation, prevent individuals with SCI from attending work or school, and interfere with community reintegration” (Houghton et al. 2013, p. 6). As well, the occurrence of a pressure ulcer can lead to rehospitalization often with an extended length of stay (Fuhrer et al. 1993; Krause 1998;Consortium for Spinal Cord Medicine 2000). In fact, pressure ulcers are reported to account for a disproportionate number of rehospitalization days (Dejong et al. 2013; Middleton et al. 2004) that are also typically much longer than length of stays for other conditions such as urinary tract infections (UTI; Dejong et al. 2013; Middleton et al. 2004; New et al. 2004). Rehospitalization secondary to pressure ulcers increase in frequency over time since discharge from initial rehabilitation but peaks at year five as seen in the United States SCI Model Systems 20-year database review (Cardenas et al. 2004).