Clinical Considerations of the Surgical Treatments of the Pressure Sore

ABSTRACT

PURPOSE: The number of sore patients are increasing steadily, especially in old ages, chronic disease and paralytic patients. Most of patients need to surgical treatment. The aim of this paper is to assess clinical analysis of surgical treatment and to consider operative methods, complications, and recurrences. METHODS: We reviewed the data from 82 consecutive patients with 101 pressure sores from March 2003 to May 2006 to discuss the occurrence rate and recurrence rate according to the site on the basis of the presence or absence of paraplegic and its etiology-the patients were categorized into three diagnostic groups traumatic paraplegics(TP), nontraumatic paraplegics (NTP), and nontraumatic nonparaplegics(NTNP). We examined the sites and sizes of each lesions, patient's state, primary causes of pressure sore, operative methods as each sites and groups, occurrence of complications and recurrences on each groups. RESULTS: In 82 patients, 52 patients were male, 30 patients were female. The male to female ratio was 1.71. Mean age was 55.8 years. 27 patients were in TP group, 35 in NTP group, and 20 in NTNP group, respectively. The common site of sore were sacral area (50.5%), greater trochanteric area(15.8%) and ischial area(13.9%). In each group, incidence rate of recurrence and complication were 11.1%, 40.7% in TP, 5.7%, 5.7% in NTP and 15%, 45% in NTNP. CONCLUSION: Surgeons must consider the general condition of the patient and possibility of recurrence and returning of daily life. We propose that cutaneous flap, fasciocutaneous flap or skin graft as well as musculocutaneous flap be useful to repair of sore site as each patient's state.