A retrospective study on flap complications after pressure ulcer surgery in spinal cord-injured patients

Abstract

Study design: A retrospective study reporting specific complications of certain skin flaps for treating pressure ulcers. Objectives: To describe the rate and type of complications after pressure ulcer surgery in patients with spinal cord injury. Setting: Germany, Rheinland Pfalz. Methods: We collected data from 352 patients treated with 421 skin flaps to determine the rate and type of complications of each skin flap used. Results: In this study, we analyzed the results of 421 skin flaps in 352 patients with a total of 657 pressure ulcers from January 2006 to December 2010. Our patients had ischial, pelvic, sacral, trochanteric and lower extremity ulcers. Ischial ulcers were most common, followed by sacral and trochanteric ulcers. There were 87 complications in 421 flaps, which was an overall rate of 21%. Suture line dehiscence was the most common complication with 27 cases (31%), followed by 22 cases of infection (25.2%), 17 cases of hematoma (19.5%), 12 cases of partial necrosis (13.7%) and 9 cases of total flap necrosis (10.3%). Conclusion: Pressure ulcers in spinal cord-injured patients are very common and difficult and expensive to treat. The high rate of complications and the associated costs suggest the importance of evaluating the efficacy of treatment options. Conservative procedures have been standardized, but there still has been limited success in establishing guidelines on how to manage complications arising from flap surgery. Our extensive documentation of flap plastics will be useful managing complications after the surgical treatment of pressure ulcers in spinal cord-injured patients.

Pressure Ulcers in Institutionalized Elderly People: Association of Sociodemographic and Clinical Characteristics and Risk Factors

“…Another risk factor associated with the PU is the prolonged stay in the same position [24]. Study found that individuals with higher amounts of fat have more chance of initial protection against PU, compared to those with less fat, although both develop injury when are not mobilized properly.…”

Clinical and Immunological Aspects of Bedsores Development

“…Пролежни являются распространенной проблемой во всем мире, затрагивающей не только госпитальных больных, но и внебольничных пациентов [13][14][15][16]. Несмотря на отсутствие статистических данных, анализ работ, посвященных пролежням, указывает на высокую частоту этой патологии.…”

“…Несмотря на отсутствие статистических данных, анализ работ, посвященных пролежням, указывает на высокую частоту этой патологии. В зависимости от контингента больных в разных лечебных учреждениях, реабилитационных центрах, хосписах пролежни фиксируются в 3-27 % случаев, достигая 75 % у лежачих оперированных больных с травмой позвоночника и спинного мозга [17][18][19][20][21][22][23][24]. Учитывая ведущее значение в развитии пролежней сдавления и обездвиживания, в практике по предотвращению возникновения пролежней основной акцент делают на лечебной гимнастике, противопролежневых матрацах, применению сосудистых препаратов.…”

Paraplegia in a patient with Von Hippel Lindau syndrome: surgical and reconstructive treatment of Marjolin’s ulcer. A case report

“…1 Chronic wounds and scar tissues are prone to an increased risk of skin cancer, known as Marjolin's ulcer. The commonest type of carcinoma arising from these lesions is squamous cell carcinoma with a bad prognosis.…”