title: Characteristics of recurrent pressure ulcers in veterans with spinal cord injury.
abstract: OBJECTIVE
  To describe characteristics of recurrent pressure ulcers (PrUs) in veterans with spinal cord injury (SCI).
  
  
  METHODS
  Descriptive, cohort study.
  
  
  METHODS
  Twenty-four veterans with SCI from 6 SCI centers in the Department of Veterans Affairs.
  
  
  METHODS
  Data from a prospective study evaluating PrUs were analyzed for 24 veterans with 29 recurrent PrUs during 9 months. Additional retrospective medical record data were analyzed for 15 veterans who received inpatient treatment.
  
  
  RESULTS
  Participants were male, 50% non-Hispanic white, with paraplegia (63%), complete SCI (83%), a mean age of 56 years, and mean time since SCI of 21 years. Most PrUs recurred (63%, n = 15 patients) in the same location as the most recent ulcer and at the ischial tuberosities (63%). Mean time to recurrence was 16.6 weeks. PrUs were stage III (28%, n = 8) or IV (45%, n = 13) with undermining (48%), necrotic slough (50%), and minimal exudate. One third were (n = 9) larger than 16 cm2. Mean Bates-Jensen Wound Assessment Tool Score was 33.63. Inpatient medical record data (n = 15) showed 73% with documentation indicating infection treated with antibiotics (53%, n = 8 patients), osteomyelitis (47%, n = 7), and/or cellulitis (13%, n = 2) noted. Plastic surgery consultation was obtained for 67% with surgery as an option for 73% (1 without consultation). Scheduled repositioning was documented for 21%.
  
  
  CONCLUSIONS
  Most PrUs were severe, located at the same anatomic site, and recurred within 4 months, suggesting that the recurrent ulcers were more likely incomplete healing of the initial PrUs. This sample of veterans with SCI provides early data on recurrent PrU characteristics.
authors.affiliation: VA Greater Los Angeles Healthcare System, Geriatric Research, Education, Clinical Center, Los Angeles, California, USA. bbatesjensen@sonnet.ucla.edu
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Bates-Jensen
authors.forename: Marylou
authors.initials: M
authors.lastname: Guihan
authors.forename: Susan L
authors.initials: SL
authors.lastname: Garber
authors.forename: Amy S
authors.initials: AS
authors.lastname: Chin
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Burns
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D014728:Veterans