Abstract
The aim of this study was to evaluate morphological characteristics of pressure ulcers, methods of surgical treatment and its effectiveness in the Clinic of Plastic and Reconstructive Surgery of Kaunas University of Medicine Hospital. A retrospective data analysis of 139 patients with pressure ulcers treated in the Clinic of Plastic and Reconstructive Surgery, Kaunas University of Medicine Hospital, from January 1996 to January 2007 was performed. A total of 139 patients were surgically treated for pressure ulcers at the Clinic of Plastic and Reconstructive Surgery, Kaunas University of Medicine Hospital, from January 1996 to January 2007. Eighty-one patients were treated repeatedly (from 1 to 7 admissions; M=1). Pressure ulcers were healed completely in 94 patients who underwent surgery during the treatment in the hospital; in 45 patients who underwent surgical treatment, pressure ulcers were partially healed, and on discharge from hospital, only small wounds were left. Pressure ulcers most commonly occur in tuber ischii area (69 cases). The mean age of patients was 42+/-13.65 years (M=31); pressure ulcers were for 8.9+/-8.5 months on average (M=31). At admission to Kaunas University of Medicine Hospital, the mean size of pressure ulcers was 42.62+/-53.27 cm(2) (M=10). The results showed that the size of pressure ulcers depends on the duration of paraplegia (P<0.05). In 93 cases, pressure ulcers were treated using myocutaneous flaps; 17 of them were closed with V-Y advancement technique over the sacral area, 35 were closed with m. gluteus rotation flap, and in 41 cases, V-Y advancement technique using hamstring flaps was used. In patients with paraplegia, the first pressure ulcer occurs after 74.79+/-61.34 months from the onset of the disease. Pressure ulcers most commonly occur over tuber ischii area. The most effective surgical treatment of pressure ulcers is closure of the wound using myocutaneous flaps (use of the hamstrings); fasciocutaneous flaps were the most commonly used method in patients who underwent surgery for the second time.
Highlights
Pressure ulcers are a necrosis of skin and underlying tissues, which develop due to tissue malnutrition in the body areas exposed to prolonged pressure
The first pressure ulcer occurs after 74.79±61.34 months from the onset of the disease
Pressure ulcers most commonly occur over tuber ischii area
Summary
Pressure ulcers are a necrosis of skin and underlying tissues, which develop due to tissue malnutrition in the body areas exposed to prolonged pressure. According to the literature data, more than two-thirds of pressure ulcers occur in patients older than 70 years. Pressure ulcers occur at a rate of 5–8%; they are the direct cause of death in 7–8% of paraplegics [1,2,3,4,5,6,7]. In an older age, pressure ulcers predominate in women, and it is associated with longer lifespan [1, 5]. Pressure ulcer occurrence over the greater trochanter of the femur and the ankle is most associated with prolonged lateral decubitus positioning of a patient. Patients incontinent of urine and feces are at higher risk of developing pressure ulcers
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