The outcome of surgical treatment of pressure sores at Mpilo Central Hospital, Zimbabwe.

OBJECTIVE

To analyze the results of surgical management of pressure sores at Mpilo Central Hospital and also to identify the characteristics of patients who develop pressure sores in our community.

DESIGN

A retrospective study of 25 patients who were treated surgically for pressure sores at Mpilo Central Hospital between January 1991 and December 1994.

SETTING

Mpilo Central Hospital, Bulawayo, Zimbabwe.

SUBJECTS

Twenty five patients who under-went surgical treatment for pressure sores.

MAIN OUTCOME MEASURES

Site of pressure sore, underlying cause of pressure sore, investigations, surgical procedures, complications, recurrence of pressure sores and length of hospital stay.

RESULTS

The mean age of the patients was 35 years (standard deviation, SD 17). There were more patients with pressure sores from rural areas (n = 15) than from urban areas (n = 10). Most pressure sores occurred in the trochanteric region, 36pc (12/33), ischial region, 33pc (11/33) and in the sacral region, 21pc (7/33). The commonest condition predisposing to pressure sores was spinal cord trauma, 48pc (12/25). Most of the patients underwent excision and flap repair (58pc) and excision and direct closure of the pressure sore (35pc). The main post operative complication was wound infection which occurred in about half the cases (n = 12). The only death in this series occurred in one patient who developed a gram negative septicaemia. The mean hospital stay was 66 days (SD37).

CONCLUSION

This study indicates that spinal cord trauma, 48pc (912/25), is the commonest condition predisposing to pressure sores in our community. The incidence of such injuries can be reduced by strict enforcement of Road Traffic Regulations and improving safety precautions at the work place. As shown in this study the use of suitable flaps reduces the recurrence rate of pressure sores.