Flap Reconstruction for Pressure Ulcers: An Outcomes Analysis.

Area of Science:

• Plastic Surgery
• Wound Healing
• Reconstructive Surgery

Background:

• Flap coverage for pressure ulcers historically has high complication rates.
• Patients undergoing pressure ulcer reconstruction often have multiple risk factors for complications.

Purpose of the Study:

• To examine a large patient series undergoing pressure ulcer flap coverage.
• To identify objective evidence linking risk factors to outcomes after flap coverage.

Main Methods:

• Retrospective chart review of 276 patients who underwent flap reconstruction for pressure ulcers (1997-2015).
• Analysis of patient characteristics to determine factors associated with complications like recurrence, dehiscence, and infection.

Main Results:

• Overall complication rate was 58.7%. Most common were wound dehiscence (31.2%) and pressure ulcer recurrence (28.6%).
• Independent risk factors for recurrence included low body mass index (<18.5), active smoking, and ischial pressure ulcers.
• Ischial pressure ulcers and preoperative osteomyelitis increased risk of wound dehiscence. Diabetes was a risk factor for wound infection.

Conclusions:

• Numerous factors are associated with high rates of major postoperative complications after pressure ulcer flap coverage.
• Risk factors must be considered when planning flap coverage.
• Implementing risk-reducing strategies before reconstruction is essential for improving patient outcomes.