[Surgical management of a series of pressure ulcers: Report of 61 cases].
BACKGROUND
Retrospective study about pressure ulcers surgical treatments in a series of 61 in 43 patients.


OBJECTIVE
To assess the management of pressure ulcers in spinal cord injury patients who had been operated in our institution.


RESULTS
On the 61 pressure ulcers, location was ischial in 35 cases, sacral in 15 cases, trochanteric in 7 cases, lateral malleolar in 2 cases, on the heel in 1 case, and 1 was located lateral to the fibular head. Comorbidities were searched pre- and postoperatively. Fifty-five muscular, cutaneous flaps or myocutaneous, 5 fasciocutaneous and 1 excision/suture were realized. The mean follow-up was 8.6 years, and we observed 9 pressure ulcers recurrences (14.8%). We had a total result of 15 (24.6%) complicated pressure ulcers, with 8 early complications (13.1%) and 7 delay (11.5%). Antibiotic therapy was prescribed in 54 (88.5%) surgery cases and 7 were operated without any (11.5%).


CONCLUSIONS
Pressure ulcers are major public health focus that need to be improved. A multidisciplinary care, mixed with education of patients are mandatory to achieve these goals: reduce complications and recurrences. Thanks to muscle sparring, perforators flap should become the gold standard of pressure ulcers surgery.
Service de chirurgie orthopédique, traumatologique, plastique et reconstructrice, assistance main, CHU J.-Minjoz, 3, boulevard A.-Fleming, 25000 Besançon, France. Electronic address: mhaiun@hotmail.com.
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M
Haiun
Service de chirurgie orthopédique, traumatologique, plastique et reconstructrice, assistance main, CHU J.-Minjoz, 3, boulevard A.-Fleming, 25000 Besançon, France.
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D
Feuvrier
Service de chirurgie orthopédique, traumatologique, plastique et reconstructrice, assistance main, CHU J.-Minjoz, 3, boulevard A.-Fleming, 25000 Besançon, France.
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T
Bayti
Service de chirurgie orthopédique, traumatologique, plastique et reconstructrice, assistance main, CHU J.-Minjoz, 3, boulevard A.-Fleming, 25000 Besançon, France.
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I
Pluvy
Service de chirurgie orthopédique, traumatologique, plastique et reconstructrice, assistance main, CHU J.-Minjoz, 3, boulevard A.-Fleming, 25000 Besançon, France.
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J
Pauchot
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult
D000900:Anti-Bacterial Agents
Complications; Escarre; Lambeau chirurgical; Lésions de la moelle épinière; Pressure sore; Pressure ulcer; Récidive; Spinal cord injuries; Surgical flap