Abstract
BackgroundSurgical repair of severe pressure ulcers (PUs) in elderly patients remains a challenge for clinicians due to the complicated comorbidities and the special physical characteristics of elderly patients. The objective of this study was to evaluate the application of couple-kissing flaps (CKF) in the reconstruction of sacral PUs in these patients.MethodsElderly patients (over 70 years) with stage 3 or stage 4 PUs who underwent CKF immediately after radical debridement between July 2012 and December 2015 were enrolled in this retrospective study. Patients’ demographics were extracted from the medical records.ResultsA total of 12 patients were involved in this study. The average age of the patients was 76.83 years (ranged from 71 to 92 years). The donor site was closed primarily in all cases. All the flaps healed uneventfully without complications. Follow-up observations were conducted for an average of 13.6 months (ranged from 9 months to 2 years). Cosmetic results were satisfactory, with no surgical site breakdown or recurrence of PU in any of the cases. Three representative cases are presented.ConclusionsThe CKF is a reliable and satisfactory option for the reconstruction of severe sacral PUs defects in elderly patients. CKF is associated with an relatively low rate of complications and recurrence.
Highlights
Surgical repair of severe pressure ulcers (PUs) in elderly patients remains a challenge for clinicians due to the complicated comorbidities and the special physical characteristics of elderly patients
According to the National Pressure Ulcer Advisory Panel (NPUAP) 2016, pressure ulcer is redefined as pressure injury: a localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device [1]
We describe a novel design of couple-kissing flap (CKF) that extends the range of therapeutic modalities in elderly patients with severe sacral PUs
Summary
Surgical repair of severe pressure ulcers (PUs) in elderly patients remains a challenge for clinicians due to the complicated comorbidities and the special physical characteristics of elderly patients. Pressure ulcers (PUs)— known as pressure injury, pressure sores, bedsores, or decubitus ulcers—are one of the most common skin injuries. The most common involved sites of PUs are the skin overlying the sacrum, coccyx, ischial tuberosity, or the. The healing process of minor to moderate PUs (NPUAP stage 1 and 2) may be slowed by ageing, medical conditions (such as diabetes or infection), smoking habits, or medications such as anti-inflammatory drugs. To date, the optimal treatment method for severe PUs (NPUAP stage 3, 4 and unstageable/deep tissue pressure injury) remains challenging in clinical settings and may typically require surgical intervention
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