Faculty Collaboration Database

Biplanar flap reconstruction for pressure ulcers: experience in patients with immobility from chronic spinal cord injuries. Am J Surg 2012 Mar;203(3):303-6; discussion 306-7

Date

03/01/2012

Pubmed ID

22364900

DOI

10.1016/j.amjsurg.2011.10.007

Scopus ID

2-s2.0-84857590742 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: Surgical therapy for advanced-stage pressure ulcers recalcitrant to healing is a widely accepted practice. The present study examined the incidence of wound recurrence after reconstruction with fasciocutaneous versus combined (biplanar) muscle and fasciocutaneous flaps.

METHODS: A retrospective review identified 90 nonambulatory patients with spinal cord injury who underwent reconstruction for persistent decubitus ulcers from 2002 to 2008. Electronic medical records were surveyed for patient comorbidities and postoperative complications. Statistical methods included the Fisher exact test and the Mann-Whitney U test with a 2-sided P value of less than .05.

RESULTS: Among 90 patients reviewed, 33% (n = 30) received fasciocutaneous flaps and 66% (n = 60) underwent biplanar reconstruction. Comorbidities were the same between cohorts with the exception of a greater prevalence of diabetes in the biplanar group (27% vs 50%; P < .05). The incidence of recurrence for biplanar flaps (25%) was significantly lower than for fasciocutaneous reconstruction (53%; P < .01).

CONCLUSIONS: Biplanar flap reconstruction should be considered for chronically immobilized patients at high risk for recurrent decubitus ulceration.

Author List

Mehta A, Baker TA, Shoup M, Brownson K, Amde S, Doren E, Shah S, Kuo P, Angelats J

Author

Erin L. Doren MD Associate Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Buttocks
Chronic Disease
Female
Humans
Male
Middle Aged
Paralysis
Postoperative Complications
Pressure Ulcer
Recurrence
Retrospective Studies
Spinal Cord Injuries
Surgical Flaps
Treatment Outcome