Postoperative gluteal skin damage associated with latent development of gluteal muscle damage.
Preceding this study, we observed two cases of concurrent postoperative gluteal skin and muscle damage with extremely high serum creatine kinase (CK) levels, both of which were unrelated to pressure-induced tissue injury. However, postoperative gluteal skin damage accompanied by gluteal muscle damage has not been previously reported and the association between gluteal skin damage, gluteal muscle damage and pressure-induced tissue injury has not previously been investigated. Therefore, we conducted this study to determine the postoperative incidence of gluteal skin damage associated with gluteal muscle damage and assess associations with postoperative serum CK levels and pressure-induced tissue injury. We prospectively evaluated postoperative incidence of gluteal skin damage and measured serum CK levels in 929 consecutive patients who underwent abdominal, urological or gynecological surgery at our hospital. Magnetic resonance imaging (MRI) of the pelvis was performed in 67 patients who consented. As a result, two of 929 patients developed postoperative gluteal skin damage accompanied by gluteal muscle damage. Gluteal muscle damage without gluteal skin damage was observed in 23 of the 67 patients who underwent MRI, and volumes of damaged gluteal muscle and postoperative serum CK levels were positively correlated. Both gluteal skin and muscle damage were distinguishable from pressure-induced tissue injury. Based on the results of this study, we could confirm the occurrence of postoperative gluteal skin damage, distinct from pressure sores, accompanied by gluteal muscle damage. We also revealed latent development of postoperative gluteal muscle damage, distinguishable from compression-induced tissue injury, without accompanying gluteal skin damage.
Department of Dermatology, Shiga Medical Center for Adults, Shiga, Japan.
Yukari
Y
Hattori
Department of Diagnostic Radiology, Shiga Medical Center for Adults, Shiga, Japan.
Takashi
T
Ikeuchi
Cybermedia Center, Osaka University, Suita, Japan.
Yoshihiro
Y
Kuroda
Department of Radiation Oncology, Shiga Medical Center for Adults, Shiga, Japan.
Kiyotomo
K
Matsugi
Department of Diagnostic Radiology, Shiga Medical Center for Adults, Shiga, Japan.
Shunsuke
S
Minami
Department of Gynecology, Shiga Medical Center for Adults, Shiga, Japan.
Toshihiro
T
Higuchi
Department of Surgery, Shiga Medical Center for Adults, Shiga, Japan.
Masazumi
M
Zaima
Department of Urology, Shiga Medical Center for Adults, Shiga, Japan.
Satoshi
S
Ishitoya
Department of Radiation Oncology, Shiga Medical Center for Adults, Shiga, Japan.
Chikako
C
Yamauchi
Department of Urology, Shiga Medical Center for Adults, Shiga, Japan.
Hiroyuki
H
Onishi
Department of Surgery, Shiga Medical Center for Adults, Shiga, Japan.
Junichiro
J
Kawamura
Department of Anesthesiology, Shiga Medical Center for Adults, Shiga, Japan.
Koichi
K
Kitoh
Graduate School of Engineering Science, Osaka University, Suita, Japan.
Osamu
O
Oshiro
Department of Healthcare Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yosuke
Y
Yamamoto
Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Atsushi
A
Utani
Department of Molecular and Internal Medicine, Hiroshima University, Hiroshima, Japan.
Noboru
N
Hattori
D000368:Aged; D000369:Aged, 80 and over; D002081:Buttocks; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries*; D010388:Pelvis / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology*; D003668:Pressure Ulcer / Q000097:blood / Q000453:epidemiology; D011446:Prospective Studies; D012867:Skin / Q000293:injuries*; D013520:Urologic Surgical Procedures / Q000009:adverse effects
D003402:Creatine Kinase
gluteal muscle damage; gluteal skin damage; magnetic resonance imaging; postoperative complication; prospective study