Characteristics of recurrent pressure ulcers in veterans with spinal cord injury.
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.
Bates-Jensen
Barbara M
BM
VA Greater Los Angeles Healthcare System, Geriatric Research, Education, Clinical Center, Los Angeles, California, USA. bbatesjensen@sonnet.ucla.edu
Guihan
Marylou
M
Garber
Susan L
SL
Chin
Amy S
AS
Burns
Stephen P
SP
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