title: Surgery for pressure ulcers in spinal cord-injured patients following a structured treatment programme: a 10-year follow-up.
abstract: With the aim to improve the outcomes for spinal cord-injured patients undergoing surgery for pressure ulcers, a structured treatment programme regulating pre- and postoperative care and rehabilitation was introduced in 2002 in Stockholm. Fifty-one consecutive patients operated on between 2002 and 2007 were included in a 10-year follow-up to evaluate the programme regarding initial healing results and long-term ulcer and health status. At one month postoperatively, 49 out of 51 (96%) patients were completely healed. Five patients (5/44, 11%) developed recurrent or new ulcers within 3 years of surgery. Two patients were re-operated on (2/44, 5%). Between 3 and 10 years after surgery, 9 patients (9/33, 27%) had a history of recurrent ulcers, and 6 (6/33, 18%) had a history of new ulcers, a total of 15 patients (15/33, 45%). Of these, three needed re-operation (3/33, 9 %). The health status values using a visual analogue rating scale were 70 (median) at 3 and 10 years compared with 30 (median) preoperatively. The good initial healing, the low ulcer recurrence rate and the raise in health status indicate the value of a structured treatment programme, especially for the first few postoperative years.
authors.affiliation: Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Anders C
authors.initials: AC
authors.lastname: Ljung
authors.affiliation: Rehab Station Stockholm/Spinalis, Research and Development Unit, Stockholm, Sweden.
authors.forename: Madeleine C
authors.initials: MC
authors.lastname: Stenius
authors.affiliation: Rehab Station Stockholm/Spinalis, Research and Development Unit, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society, Division of Neurodegeneration, Section Neurorehabilitation, Karolinska Institute, Stockholm, Sweden.
authors.forename: Sabahudin
authors.initials: S
authors.lastname: Bjelak
authors.affiliation: Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.|Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors.forename: Jakob F
authors.initials: JF
authors.lastname: Lagergren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D003668:Pressure Ulcer / Q000209:etiology* / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000150:complications*; D013548:Sweden
keywords: Follow-up; Pressure ulcer surgery; Spinal cord injury; Treatment programme