National perioperative outcomes of flap coverage for pressure ulcers from 2005 to 2015 using American College of Surgeons National Surgical Quality Improvement Program

Tran, Bao Ngoc N.; Chen, Austin D.; Kamali, Parisa; Singhal, Dhruv; Lee, Bernard T.; Fukudome, Eugene Y.

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자료유형: 학술저널

저자정보: Tran, Bao Ngoc N. (Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School) Chen, Austin D. (Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School) Kamali, Parisa (Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School) Singhal, Dhruv (Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School) Lee, Bernard T. (Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School) Fukudome, Eugene Y. (Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School)

저널정보: 대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제45권 제5호

발행연도: 2018.1

수록면: 418 - 424 (7page)

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Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005-2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.

#Pressure ulcer #Reconstructive surgical procedures #Wounds and injuries

참고문헌 (25)

참고문헌 신청

Lyder CH / 2003 / Pressure ulcer prevention and management / JAMA 289:223~226

Reddy M / 2006 / Preventing pressure ulcers: a systematic review / JAMA 296:974~984

Goodman CM / 1999 / Evaluation of results and treatment variables for pressure ulcers in 48 veteran spinal cord-injured patients / Ann Plast Surg 42:665~672

Baumgarten M / 2003 / Risk factors for pressure ulcers among elderly hip fracture patients / Wound Repair Regen 11:96~103

Lindholm C / 2008 / Hip fracture and pressure ulcers: the Pan-European Pressure Ulcer Study: intrinsic and extrinsic risk factors / Int Wound J 5:315~328

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