Which area is a common site of integumentary breakdown in children with spina bifida?

• A. Perianal Decubiti
• B. Apex Of Spinal Kyphotic Curve
• C. Weight-Bearing Over Bony Prominences (Sitting Or Standing)
• D. Ammonia Burns From Incontinence

Answer: (C)

Pressure injuries in kids with spina bifida mostly come from sustained pressure over areas that bear weight, especially when sensation or mobility are limited and a person can’t regularly shift position. Prolonged load on a bony prominence reduces blood flow to the skin and underlying tissues, leading to ischemia and tissue breakdown. That’s why the best answer points to weight-bearing over bony prominences during sitting or standing—the ischial tuberosities when seated and other prominent bones that bear weight during transfer or standing are the parts most at risk.

Perianal areas can be affected, but they’re not the primary or most common site compared to weight-bearing prominences. The apex of a spinal kyphotic curve isn’t a typical pressure site. Ammonia burns from incontinence describe chemical irritation rather than pressure ulcers, though moisture and incontinence can contribute to skin problems if not managed. Prevention hinges on relief of pressure through regular repositioning, using cushions or surfaces that reduce pressure, keeping the skin clean and dry, and regularly inspecting for early signs of breakdown.