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© 2020, University Library System, University of Pittsburgh. All rights reserved. Lack of specialist beds, inadequate finance and shortage of skilled staff make it difficult for Spinal Cord Injury Centres (SCICs) in the United Kingdom (UK) to admit all newly injured individuals. Length of stay of those admitted can be too brief. At discharge, follow-up care is sparse and inadequate. We therefore propose that specialist spinal units redefine their roles and act as catalysts to build capacity by enhancing expertise in the wider community. SCICs can devolve certain tasks locally to less specialised units with their support, training, and guidance. This Commentary further proposes that use of Digital Health Technologies, (i.e., to deploy telemedicine, telehealth, and telerehabilitation), can enhance rehabilitation opportunities. The authors set-forth their vision for a comprehensive web portal that will serve as a primary resource for evidence-based practice, information on guidelines, care pathways, and protocols of SCI management. At any stage during the acute management of SCI and following discharge, rehabilitation specialists could conduct remote consultation with persons with SCI and acute care specialists via the web portal, allowing timely access to specialist input and better clinical outcomes. The proposed portal would also provide information, advice and support to persons with SCI and their family members. The strategic use of digital health technologies has been shown to result in cost and time savings and increase positive outcomes.

People suffering from neurological disabilities are at high risk of developing pressure ulcers. Prolonged seating and pressure, shearing forces and stress are the main causes for microcirculatory occlusion that results in ischemia. Due to theincreased demand for oxygen, irreversible changes in muscles may occur after as little as 2 h of uninterrupted pressure. The skin in comparison can withstand direct pressures of up to 12 h. Therefore when it breaks down, the skin reveals already established soft tissue damage. The regular lifting that patients with spinal cord injury have been taught may be too brief to protect against pressure ulcers. Other factors come into play, like lack of sensation, spasticity, chronic contractures, disuse atrophy, and poor general condition. Pressure ulcers are predominant in the sacral area, and heels. When they occur, they are monitored according to the European Pressure Ulcer Advisory Panel grading system. Preventative measures take into account the above facts, whereas treatment options are conservative (non-surgical) methods and surgery. Post-healing measures include a gradual and time monitored mobilisation protocol of the patient with an appropriate cushion.