A 9-year retrospective evaluation of 102 pressure ulcer reconstructions

Author:

Kenneweg K. A.1,Welch M. C.2,Welch P. J.3

Affiliation:

1. The University of Toledo College of Graduate Studies, The University of Toledo College of Medicine

2. University of Toledo Medical Center 3000 Arlington Avenue, Mail Stop 1095 Toledo, Ohio 43614 US

3. Bowling Green State University, 216 Health & Human Services Building (Ridge Street), Bowling Green, Ohio 43403, US

Abstract

• Objective: Several pressure ulcer (PU) risk factors including paralysis and age greater than 70 have been identified, while others such as nutrition are debated. The object of this study is to identify perioperative risk factors that may predict improved outcomes and reduced complications in primary and recurrent PU reconstructions. • Method: A retrospective chart review of patients treated surgically for PUs from 2004 to 2013 at the University of Toledo Medical Center, Toledo, Ohio, US, was completed. Data collected included ulcer and medical history, as well as risk factors, complications and postoperative outcome. Data were statistically analysed for perioperative variances between primary and recurrent ulcers and closure status. • Results: A total of 49 patients with 102 reconstructions were reviewed. Spinal cord injured patients accounted for 90% receiving flap coverage of ulcers. Numerous differences between primary and recurrent ulcers were identified, including ulcer location, patient nutritional status, wound infection, postoperative course and recurrence. Multivariate analysis revealed a flap reconstruction prediction model using creatinine, haematocrit, haemoglobin, and prealbumin that is able to successfully predict closure outcome in 83.6% of cases. • Conclusion: Many factors play a role in the development, course and treatment of PUs. It is vital to understand the role of patient risk factors in the development of PUs, to direct subsequent management and reconstruction, and to prevent future recurrences.

Publisher

Mark Allen Group

Subject

Nursing (miscellaneous),Fundamentals and skills

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