Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Int Wound J. 2018 Dec;15(6):900-908. doi: 10.1111/iwj.12942. Epub 2018 Jun 28.
Pressure sores remain a common health problem, particularly among the physically limited or bedridden elderly, and can cause significant morbidity and mortality. This study aimed to present our surgical treatment and strategy for patients with multiple pressure sores. Between January 2010 and December 2016, 18 patients were enrolled. After adequate debridement, pressure sores were managed based on our treatment protocol. Patients' age, aetiology, defect size and location, flap reconstruction, outcome, and follow-up period were reviewed. A total of 10 men and 8 women (average age, 82.3 years) with a mean follow-up period of 28.3 months (6-72 months) were included. The mean defect area was 63.7 cm . The most common aetiology of the bedridden state was cerebrovascular accident (38.89%), and the most frequent sores were trochanteric pressure sores (53.57%). The average operative time and blood loss were 105.5 minutes and 100.8 mL, respectively. No haemodynamic variation or blood transfusion was noted during the surgery. The complication rate for each sore was 10.7%, including late recurrence. In conclusion, treating pressure ulcers requires careful patient education, intensive multidisciplinary optimisation, and meticulous wound care, and our treatment protocol ensures a shorter surgery time, less bleeding, and low complication rate.
压疮仍然是一个常见的健康问题,尤其是在身体受限或卧床不起的老年人中,可能会导致严重的发病率和死亡率。本研究旨在介绍我们对多发性压疮患者的手术治疗和策略。2010 年 1 月至 2016 年 12 月,共纳入 18 例患者。在充分清创后,根据我们的治疗方案处理压疮。回顾了患者的年龄、病因、缺损大小和位置、皮瓣重建、结果和随访时间。共纳入 10 例男性和 8 例女性(平均年龄 82.3 岁),平均随访 28.3 个月(6-72 个月)。缺损面积的平均值为 63.7cm²。卧床状态最常见的病因是脑血管意外(38.89%),最常见的压疮是转子部压疮(53.57%)。手术时间和失血量的平均值分别为 105.5 分钟和 100.8ml,手术过程中未出现血流动力学变化或输血。每个压疮的并发症发生率为 10.7%,包括晚期复发。总之,治疗压疮需要对患者进行仔细的教育、强化多学科优化和精心的伤口护理,我们的治疗方案确保了较短的手术时间、较少的出血和较低的并发症发生率。