Neurosurgery - Collar care

Introduction

This leaflet has been produced to give you information about protecting and caring for your skin whilst wearing your neck collar. It is not meant to replace discussion between you and your Physiotherapist, Nurse or Surgeon, but may act as a starting point for discussion.

Your consultant should have explained the reason for having to wear your hard neck collar. This leaflet is designed to provide you with information on how to apply and remove your neck collar and advises on cleaning and hygiene.

Your physiotherapist or nurse will teach you how to take care of your collar before you are discharged. Any problems or concerns you may have can be directed to the physiotherapist or nurse looking after you.

If after reading this leaflet, you require further explanation please discuss this with a member of the team who have been caring for you.

Applying/removing your collar

To remove collar when lying down

• Lie flat in bed without a pillow
• Keep your head in a neutral position. Do not bend your neck forward, backward or from side to side
• Undo the Velcro straps. Remove the front of the collar and slide the back panel out from under neck

To replace collar when lying down

1. Slide the back panel carefully behind the neck. Make sure it is centred evenly. Long hair should be placed outside the collar.
2. Place the front panel under the chin ensuring it is central with the sides sitting on top of the shoulders.
3. Attach the back straps to the front, one at a time and ensure the collar feels secure.

To remove collar when sitting (You must have permission from your doctor to do this)

• Sit up straight in a firm chair in front of a mirror
• Keep your head and neck in a neutral position (nose in-line with belly button, chin level)
• Do not bend your neck forward, backward or side-ways. Be very careful not to move your neck while this is done
• Remove the collar by undoing the Velcro straps

To replace collar when sitting

1. Place the back panel carefully behind the neck. Make sure it is centred evenly. Long hair should be placed outside the collar.
2. Place the front panel under the chin ensuring it is central with the sides sitting on top of the shoulders.
3. Attach the back straps to the front, one at a time and ensure the collar feels secure.

Skin care whilst wearing a hard collar

You must clean and check your skin every day whilst wearing a collar, you may find you need help with this, and the ward staff will be happy to show your carers how to assist you.

We don’t recommend placing pads or foam underneath the collar as this can add more pressure to certain points on your skin.

You need to check for any red areas, tenderness or breaks to the skin and you must contact us for advice if you develop any sores on your skin underneath the collar.

Wash and dry your skin as normal. Ensure your skin is clean and dry before you reapply your clean collar.

Cleaning the collar (one collar can be cleaned whilst you wear the second collar)

1. Clean the front and back panels of the collar and replace the soiled pads with clean ones as directed below.
2. Peel the soiled, pads off. Look carefully at the shape as you remove them so that you can reposition the clean pads properly.
3. The pads attach with Velcro.
4. Wash the pads with mild facial soap and water.
5. Do not use bleach or harsh detergents.
6. Thoroughly rinse the pads with clean water.
7. Wring out the excess water and squeeze in a towel.
8. Lay the pads out flat to air dry. It should take less than 60 minutes for them to dry.
9. Wipe the plastic collar shell clean with mild soap and water.
10. When re-attaching the pads ensure no plastic touches the skin.

Important information

Please note the following:

1. The collar should be tight but comfortable. If the collar is not on tight enough it will not support your injury and you may experience pain or risk further damage to your neck. If worn too loose it may also rub and can cause skin soreness and irritation.
2. The collar should be always kept on unless you have received different instructions from your Nurse, Physiotherapist or Consultant. It should be removed at least once daily for washing and checking your skin and exchanging the pads for clean ones.
3. The Collar will only limit movement within your neck, not eliminate it completely. It is important that you monitor your posture to prevent slouching and avoid any heavy lifting and carrying.
4. The pads within the collar are removable and can be hand washed. They should be fully dry prior to wearing them and the collar should not be worn without them.
5. Bathing and showering is not permitted unless you are given special instruction from your consultant.
6. If you feel you may need guidance with washing and dressing technique please discuss this with the Occupational Therapist on the ward prior to discharge.

If you have any problems with the collar, please do not hesitate to contact the Orthotics team on: Email: orthotics@nca.nhs.uk

Discharge and follow up

You will be expected to attend for follow-up x-rays to monitor the healing process. If you have not received this appointment within 6 weeks, then please contact your consultant’s secretary.

Other information