title: Application of skin traction for surgical treatment of grade IV pressure sore: a clinical report of 160 cases.
abstract: METHODS
  Retrospective clinical study.
  
  
  OBJECTIVE
  To assess the method of primary surgical closure of pressure sores developed by the Ruixin Hospital for burns.
  
  
  METHODS
  Nanjing, China.
  
  
  METHODS
  The study included 235 grade IV pressure sores of 160 patients, M:F = 119:41. Their age ranged from 19 to 93 years (mean = 47.4, s.d. ± 15.7). The primary disease was spinal cord injury in 141 patients (88.1%). The location of sore spread over ischial, sacrococcygeal and trochanteric regions. The largest pressure sore measured 15 × 25 cm(2). The time from onset of sore to admission ranged from 3 months to 22 years (mean = 35.5 months, s.d. ± 55.8). Local preoperative preparation included external skin traction using adhesive tapes, wound cleaning and change of dressing. General condition was checked and improved by supportive measures. Operation procedures included thorough debridement, excision of hidden minor scars, mobilizing opposing skin flaps and meticulous haemostasis before closure. Skin traction continued after the operation until the wound was healed.
  
  
  RESULTS
  All but 10 sores healed primarily. These 10 sores healed after a revision. The length of stay in hospital ranged from 20 to 140 days (mean = 45.1 days, s.d. ± 21.1). Follow-up period was 2-51 months (mean = 22 months, s.d. ± 12.5). Two ischial sores recurred owing to long sitting. They were cured with the same method. Three illustrative cases are presented.
  
  
  CONCLUSIONS
  The method is simple and enjoys a high success rate with a short stay in hospital and hence is cost effective. The recurrence is rare.
authors.affiliation: Nanjing Ruixin Hospital for Burns, Nanjing, PR China.
authors.forename: X
authors.initials: X
authors.lastname: Chen
authors.forename: Z
authors.initials: Z
authors.lastname: Jiang
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.forename: D
authors.initials: D
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D003668:Pressure Ulcer / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000150:complications*; D014143:Traction / Q000379:methods* / Q000706:statistics & numerical data; D006113:United Kingdom; D055815:Young Adult