Two-stage treatment of ischial pressure ulcers in spinal cord injury patients: Technique and outcomes over 8 years

Jordan, Sumanas W.; Garza, Mauricio De La; Lewis, Victor L.

doi:10.1016/j.bjps.2017.01.004

Cited by 14 publications

(16 citation statements)

References 33 publications

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“…Most of the wounds in this study were over the ischial tuberosities, which is consistent with previously published literature . This relates to the fact that most paralysed patients spend much of their day sitting in their manual or power wheelchairs, and the seating systems are unfortunately not always optimised.…”

Section: Discussionsupporting

confidence: 89%

“…In addition, the patients who had had previous surgery were 5.9 times more likely to develop complications. This aligned with the finding from Jordan et al, who found more dehiscence in ischial tuberosity pressure ulcer reconstructions in patients who had had previous surgeries . In addition, in the subgroup of patients that did not have a previous surgery (Treatment group N = 29; Control N = 12), there was a significant reduction in the percentage of patients who developed a complication (Treatment group 3.4% v. Control 33.3%, P = 0.0202).…”

Section: Discussionsupporting

confidence: 87%

“…Most common known predictive factors for complications in pressure ulcer reconstruction are BMI < 18, smoking, osteomyelitis, diabetes, ulcers located over the ischial tuberosity, and a previous reconstruction . In the current study, no correlation was found between complications and BMI, diabetes, or the proportion of patients with multiple wounds.…”

Section: Discussioncontrasting

confidence: 64%

“…Most of the wounds in this study were over the ischial tuberosities, which is consistent with previously published literature. 4,[7][8][9][10] This relates to the fact that most paralysed patients spend much of their day sitting in their manual or power wheelchairs, and the seating systems are unfortunately not always optimised. Often, relating to their SCI and muscle wasting, there also is a lack of good-quality soft tissue coverage over the bony prominences in this area.…”

Section: Discussionmentioning

confidence: 99%

“…4 Overall complications of 21% to 58.7% [5][6][7][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 pressure ulcers as well, 9,10 and wound dehiscence in general is the most common complication. 7,8 Typical risk factors for wound-healing complications after pressure ulcer reconstruction include BMI < 18, smoking, 7,11 osteomyelitis, diabetes, and ulcers located over the ischial tuberosity.…”

mentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 64%