title: Reducing the period of immobilization following pressure sore surgery: a prospective, randomized trial.
abstract: The cost to care for a patient with pressure sores can be exorbitant. One part of this expense results from the prolonged postoperative immobilization. Published protocols report 3 to 8 weeks of immobilization; however, there are no studies that establish longer periods to be superior. To justify our 3-week protocol, we conducted a prospective, randomized trial of 2 versus 3 weeks of postoperative immobilization. Each patient was randomized preoperatively to either 2 or 3 weeks of postoperative immobilization. A total of 42 patients with a diagnosis of paraplegia, tetraplegia, or multiple sclerosis and a solitary pressure sore were enrolled over 5 years. The complication rates in the two groups (9 of 23, or 39 percent, for the 2-week group and 9 of 19, or 47 percent, for the 3-week group) were not statistically different (p < 0.493). However, the time to mobilization was significantly reduced in the 2-week group (16.1 +/- 6.1 versus 22.9 +/- 4.9 days, p < 0.0003), as was the time to achieve sitting (21.2 versus 28.9 days, p < 0.0026). In summary, 2 weeks of postoperative immobilization following surgery is adequate for uncomplicated solitary pressure sores.
authors.affiliation: Department of Surgery and Rehabilitation Medicine, University of Washington Medical Center, USA.
authors.forename: F F
authors.initials: FF
authors.lastname: Isik
authors.forename: L H
authors.initials: LH
authors.lastname: Engrav
authors.forename: R P
authors.initials: RP
authors.lastname: Rand
authors.forename: P
authors.initials: P
authors.lastname: Kierney
authors.forename: D D
authors.initials: DD
authors.lastname: Cardenas
mesh_terms: D006801:Humans; D007103:Immobilization; D007902:Length of Stay; D009103:Multiple Sclerosis / Q000150:complications; D010264:Paraplegia / Q000150:complications; D011182:Postoperative Care; D011183:Postoperative Complications; D003668:Pressure Ulcer / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors