A retrospective study: Multivariate logistic regression analysis of the outcomes after pressure sores reconstruction with fasciocutaneous, myocutaneous, and perforator flaps

Chiu, Yu–Jen; Liao, Wen-Chieh; Wang, Tien‐Hsiang; Shih, Yu-Chung; Ma, Hsu; Lin, Chih‐Hsun; Wu, Szu-Hsien; Perng, Cherng-Kang

doi:10.1016/j.bjps.2017.04.004

Cited by 24 publications

(38 citation statements)

References 13 publications

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“…The average operative time was 105.5 minutes without intraoperative blood transfusion or intraoperative haemodynamic variation. The overall complication rate was low (10.7%, 6 of 56 pressure sores) compared with previous studies (4.57%‐46.4%) …”

Section: Discussioncontrasting

confidence: 58%

“…The overall complication rate was low (10.7%, 6 of 56 pressure sores) compared with previous studies (4.57%-46.4%). 18,19 In our treatment protocol, we performed VAC therapy after wound debridement as a bridge to final reconstruction. VAC, also known as negative pressure wound therapy, is a well-known wound care system for the treatment of complex wounds.…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment and strategy in patients with multiple pressure sores

Chiang

Wang

Tzeng

2018

International Wound Journal

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Pressure sores remain a common health problem, particularly among the physically limited or bedridden elderly, and can cause significant morbidity and mortality. This study aimed to present our surgical treatment and strategy for patients with multiple pressure sores. Between January 2010 and December 2016, 18 patients were enrolled. After adequate debridement, pressure sores were managed based on our treatment protocol. Patients' age, aetiology, defect size and location, flap reconstruction, outcome, and follow-up period were reviewed. A total of 10 men and 8 women (average age, 82.3 years) with a mean follow-up period of 28.3 months (6-72 months) were included. The mean defect area was 63.7 cm . The most common aetiology of the bedridden state was cerebrovascular accident (38.89%), and the most frequent sores were trochanteric pressure sores (53.57%). The average operative time and blood loss were 105.5 minutes and 100.8 mL, respectively. No haemodynamic variation or blood transfusion was noted during the surgery. The complication rate for each sore was 10.7%, including late recurrence. In conclusion, treating pressure ulcers requires careful patient education, intensive multidisciplinary optimisation, and meticulous wound care, and our treatment protocol ensures a shorter surgery time, less bleeding, and low complication rate.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Surgical treatment and strategy in patients with multiple pressure sores

Chiang

Wang

Tzeng

2018

International Wound Journal

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“…A 27% wound recurrence has been reported after flap reconstruction, and the recurrence was related to original wound defect size . Overall complications of 21% to 58.7% and recurrences of 16% after a mean follow‐up of 55 months have been noted, with more recurrences over the ischial tuberosities . Previous reconstruction has been shown to be a risk factor for postoperative dehiscence in ischial tuberosity pressure ulcers as well, and wound dehiscence in general is the most common complication .…”

Section: Introductionmentioning

confidence: 99%

“…4 Overall complications of 21% to 58.7% 5-8 and recurrences of 16% after a mean follow-up of 55 months have been noted, with more recurrences over the ischial tuberosities. 6 Previous reconstruction has been shown to be a risk factor for postoperative dehiscence in ischial tuberosity…”

mentioning

confidence: 99%

Incisional negative pressure therapy reduces complications and costs in pressure ulcer reconstruction

Papp

2018

International Wound Journal

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Complications after pressure ulcer reconstruction are common. A complication rate of 21% to 58% and a 27% wound recurrence has been reported. The aim of this study was to decrease postoperative wound‐healing complications with incisional negative pressure wound therapy (iNPWT) postoperatively. This was a prospective non‐randomised trial with a historic control. Surgically treated pressure ulcer patients receiving iNPWT were included in the prospective part of the study (Treatment group) and compared with the historic patient cohort of all consecutive surgically treated pressure ulcer patients during a 2‐year period preceding the initiation of iNPWT (Control). There were 24 patients in the Control and 37 in the Treatment groups. The demographics between groups were similar. There was a 74% reduction in in‐hospital complications in the Treatment group (10.8% vs 41.7%, P = 0.0051), 27% reduction in the length of stay (24.8 vs 33.8 days, P = 0.0103), and a 78% reduction in the number of open wounds at 3 months (5.4 vs 25%, P = −0.0481). Recurrent wounds and history of previous surgery were risk factors for complications. Incisional negative pressure wound therapy shortens hospital stay, number of postoperative complications, and the number of recurrent open wounds at 3 months after reconstructive pressure ulcer surgery, resulting in significant cost savings.

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“…A history of previous pressure ulcer increases the risk of developing a second pressure ulcer, particularly in the ischial region [1,6] . Fortunately, many of the flaps commonly used for pressure ulcer treatment can be readvanced or reused under certain conditions.…”

Section: Introductionmentioning

confidence: 99%