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在由整形外科和物理医学与康复团队控制治疗的脊髓损伤患者中,压疮重建后的复发率。

Recurrence rate after pressure ulcer reconstruction in patients with spinal cord injury in patients under control by a plastic surgery and physical medicine and rehabilitation team.

作者信息

Paker Nurdan, Buğdaycı Derya, Gökşenoğlu Gökşen, Akbaş Dilber, Korkut Taner

机构信息

Department of Physical Medicine and Rehabilitation, İstanbul Physical Therapy and Rehabilitation Training and Research Hospital, İstanbul, Turkey.

Department of Plastic, Reconstructive and Aesthetic Surgery, Private Elite Polyclinic, İstanbul, Turkey.

出版信息

Turk J Phys Med Rehabil. 2018 Nov 6;64(4):322-327. doi: 10.5606/tftrd.2018.2175. eCollection 2018 Dec.

DOI:10.5606/tftrd.2018.2175
PMID:31453529
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6648030/
Abstract

OBJECTIVES

This study aims to evaluate the recurrence rate after reconstruction of the pressure ulcer (PU) in patients with spinal cord injury (SCI) treated by a team consisted of plastic surgery and physical medicine and rehabilitation specialists.

PATIENTS AND METHODS

Between February 2002 and December 2008, a total of 39 patients with SCI (32 males, 7 females; mean age 38.1±6.7 years; range, 19 to 71 years) aged ≥18 years who were admitted to our rehabilitation unit and operated for PU were retrospectively analyzed. Demographic data and physical examination findings and potential risk factors for recurrence of PU were recorded. All patients were followed for the PU recurrence after reconstruction.

RESULTS

The recurrence of PU was observed in nine patients (23.1%) with SCI. The most common recurrent PU was sacral ulcer (82.1%), followed by ischial ulcers (20.5%), trochanteric ulcers (15.4%), and others (2.6%). No risk factor was found to be statistically significant between the two groups in terms of both demographic risk factors and clinical risk factors. No statistically significant effect of clinical and demographic risk factors was found on the risk of recurrence of PU.

CONCLUSION

Our study results suggest that collaboration between plastic surgery and physical medicine and rehabilitation department with a strict follow-up protocol may help to prevent recurrences of PU after surgery in SCI patients.

摘要

目的

本研究旨在评估由整形外科、物理医学与康复专科医生组成的团队治疗的脊髓损伤(SCI)患者压疮(PU)重建后的复发率。

患者与方法

回顾性分析2002年2月至2008年12月期间,入住我们康复单元并接受PU手术的39例年龄≥18岁的SCI患者(32例男性,7例女性;平均年龄38.1±6.7岁;范围19至71岁)。记录人口统计学数据、体格检查结果以及PU复发的潜在危险因素。所有患者在重建后均随访PU复发情况。

结果

观察到9例(23.1%)SCI患者出现PU复发。最常见的复发性PU是骶部溃疡(82.1%),其次是坐骨溃疡(20.5%)、转子溃疡(15.4%)和其他溃疡(2.6%)。在人口统计学危险因素和临床危险因素方面,两组之间均未发现有统计学意义的危险因素。未发现临床和人口统计学危险因素对PU复发风险有统计学意义的影响。

结论

我们的研究结果表明,整形外科与物理医学与康复科之间的合作以及严格的随访方案可能有助于预防SCI患者手术后PU的复发。

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本文引用的文献

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Prevalence of pressure ulcers in Thai wheelchair users with chronic spinal cord injuries.泰国慢性脊髓损伤轮椅使用者中压疮的患病率。
Spinal Cord. 2015 Oct;53(10):767-71. doi: 10.1038/sc.2015.77. Epub 2015 May 5.
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Comparison of outcomes of pressure sore reconstructions among perforator flaps, perforator-based rotation fasciocutaneous flaps, and musculocutaneous flaps.穿支皮瓣、穿支蒂旋转筋膜皮瓣和肌皮瓣在压疮重建中的效果比较。
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Comparison of gluteal perforator flaps and gluteal fasciocutaneous rotation flaps for reconstruction of sacral pressure sores.臀肌穿支皮瓣与臀肌筋膜皮瓣在骶尾部压疮修复中的比较。
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