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

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.