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脊髓损伤和痉挛患者压疮手术的治疗结果

Outcomes of Pressure Sore Surgery in Patients with Spinal Cord Injury and Spasticity.

作者信息

Negosanti Luca, Sanguinetti Giorgio, Musumeci Gaia, Bettini Francesca, Salucci Pamela, Rucci Paola, Landi Siriana, Sgarzani Rossella

机构信息

From the Specialized Care Unit, Montecatone Rehabilitation Institute, Imola, Italy.

Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.

出版信息

Plast Reconstr Surg Glob Open. 2024 Mar 1;12(3):e5632. doi: 10.1097/GOX.0000000000005632. eCollection 2024 Mar.

Abstract

BACKGROUND

Spasticity is a serious complication of spinal cord injury/disease (SCI/D) that affects 60%-80% of patients with this condition. The presence of spasticity can have a significant impact on the outcomes of reconstructive surgical interventions, such as those on pressure sores (PSs). Moreover, in the conservative treatment of PSs, spasticity may prevent maintaining adequate postures to avoid skin friction or traction. The aim of this study is to describe the PS reconstruction outcomes in a cohort of patients with SCI/D affected by spasticity.

METHODS

In this retrospective study of patients with SCI/D consecutively admitted to Montecatone Rehabilitation Institute between October 2013 and March 2022, 54 PSs were treated in 46 people with spasticity.

RESULTS

Postsurgery complications occurred in 26 of 54 treated PS, of which seven were major. Eleven patients experienced more than one complication. The overall incidence of postsurgical complications was 48.1%, and the incidence of major complications was 13%. Median length of hospital stay was 3.8 versus 1.8 months. Compared with other reports in the literature of PS reconstruction in patients with SCI/D, we found higher rates of overall, minor, and major complications.

CONCLUSIONS

Spasticity proved to be an important condition to consider, and its treatment requires specialized physicians. The collaboration between plastic surgeons and spasticity specialists is crucial to define the best treatment to reduce postoperative complications.

摘要

背景

痉挛是脊髓损伤/疾病(SCI/D)的一种严重并发症,影响60%-80%的此类患者。痉挛的存在会对重建手术干预的结果产生重大影响,例如对压疮(PSs)的手术。此外,在PSs的保守治疗中,痉挛可能会妨碍维持适当姿势以避免皮肤摩擦或牵拉。本研究的目的是描述一组受痉挛影响的SCI/D患者的PS重建结果。

方法

在这项对2013年10月至2022年3月期间连续入住蒙特卡托内康复研究所的SCI/D患者的回顾性研究中,46名痉挛患者共治疗了54处PSs。

结果

54处接受治疗的PSs中有26处出现术后并发症,其中7处为严重并发症。11名患者经历了不止一种并发症。术后并发症的总体发生率为48.1%,严重并发症的发生率为13%。中位住院时间为3.8个月,而其他报道为1.8个月。与文献中关于SCI/D患者PS重建的其他报道相比,我们发现总体、轻微和严重并发症的发生率更高。

结论

痉挛被证明是一个需要考虑的重要情况,其治疗需要专业医生。整形外科医生和痉挛专家之间的合作对于确定减少术后并发症的最佳治疗方法至关重要。

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