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August 11, 2025 72 mins

Krissy Dilger of the Siegel Rare Neuroimmune Association (SRNA) was joined by experts Janet Dean, MS, RN, CRRN, CRNP and Florence Hanssen, RN to discuss skin health and the prevention of skin breakdown. The conversation covered the structure of the skin and how paralysis affects skin health [00:01:48]. Key topics included the role of daily skin checks, moisture management, and the importance of pressure relief [00:11:48]. They also reviewed how nutrition, rehabilitation, and technology can aid in the prevention and treatment of skin breakdown [00:17:51]. Lastly, the episode covered the signs of serious skin issues and when to seek medical attention [00:50:18].


Janet Dean, MS, RN, CRRN, CRNP attended nursing school at the University of Michigan, completing a master’s degree in parent-child nursing in 1979. She is a board-certified Pediatric Nurse Practitioner and is also a Certified Rehabilitation Registered Nurse. She has over 30 years of experience in the specialty of pediatric rehabilitation. Prior to becoming a nurse practitioner, Ms. Dean enjoyed 10 years as a staff nurse on a pediatric rehabilitation unit caring for children with physical and developmental disability. As a nurse practitioner for the International Center for Spinal Cord Injury, she specialized in the prevention and treatment of the common health consequences of pediatric spinal cord injury. The focus of her practice is on health promotion and health maintenance.


Florence Hanssen, RN is a nurse coordinator at the Kennedy Krieger Institute’s International Center for Spinal Cord Injury. She obtained her licensure in 1993, and her bachelor’s in nursing science from Ohio University in 2014. Her primary interests are in wound care and the continuous outpatient healthcare for those living with spinal cord injury/ disease. She earned her wound care nurse certification in 2023.


00:00:00 Introduction

00:00:17 Meet the Experts

00:01:48 Understanding Skin Structure and Function

00:03:59 What is Skin Breakdown?

00:05:49 Impact of Paralysis on Skin Health

00:08:15 Causes of Skin Breakdown

00:11:48 Preventing Skin Breakdown

00:14:00 Mechanical Injuries and Skin Health

00:16:21 Hygiene Practices for Skin Health

00:17:51 Nutrition and Skin Health

00:20:17 Rehabilitation and Skin Health

00:23:15 Preventing Pressure Ulcers

00:28:58 Managing Muscle Spasms

00:31:28 Identifying and Treating Minor Skin Breakdown

00:34:14 Understanding and Treating Minor Skin Irritations

00:36:24 Identifying Pressure Points and Vulnerable Areas

00:40:17 Managing Scrapes and Tears During Transfers

00:43:21 Preventing Skin Breakdown Under Braces

00:47:20 Addressing Skin Breakdown in Perineal Areas

00:50:18 Recognizing and Treating Serious Skin Breakdown

01:03:46 The Role of Technology and Resources in Skin Care

01:06:32 Final Thoughts and Advice

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