Resultados del tratamiento quirúrgico de úlceras por presión mediante colgajos locales / Outcomes of Surgical Treatment of Pressure Ulcers Using Local Flaps

RESUMEN Introducción: Las úlceras por presión son soluciones de continuidad que aparecen en la piel que cubre las prominencias óseas, cuando estas soportan una presión externa continuada que interfiere con la circulación sanguínea correcta y la nutrición de los tejidos. Objetiv o: Evaluar los resultados del tratamiento quirúrgico de las úlceras por presión mediante los diferentes tipos de colgajos locales. Métodos: Se realizó un estudio descriptivo, ambispectivo y de corte longitudinal. El universo estuvo conformado por todos los pacientes que presentaron diagnóstico de úlcera por presión con criterio quirúrgico. La muestra fueron 72 pacientes constituyendo un total de 84 úlceras por presión, que cumplieron con los criterios de inclusión. Resultados: El sexo masculino predominó en el estudio; con rango de edad entre 19 y 29 años. Las úlceras sacras fueron las más frecuentes y de mayor tamaño y el colgajo más utilizado para el cierre fue el de rotación y avance. Se obtuvo un resultado satisfactorio en el 82,5 por ciento de los casos. Conclusiones: Se logró una adecuada cobertura tisular y almohadillado de la zona, además de ausencia de complicaciones que interfirieran con el resultado final(AU)

ABSTRACT Introduction: Pressure ulcers are continuity solutions that appear on the skin that covers bony prominences, when these bear continuous external pressure that interferes with correct blood circulation and nutrition of tissues. Objective: To evaluate the outcomes of surgical treatment of pressure ulcers using different types of local flaps. Methods: A descriptive, ambispective and longitudinal study was carried out. The population consisted of all the patients who presented diagnosis of pressure ulcer with surgical criteria. The sample consisted of 72 patients, with a total of 84 pressure ulcers, who met the inclusion criteria. Results: The male sex predominated in the study, together with the age range 19-29 years. Sacral ulcers were the most frequent and largest, and the most used flap for closure was the rotation and advancement flap. Satisfactory outcomes were obtained in 82.5 percent of the cases. Conclusions: Adequate tissue coverage and padding of the area was achieved, as well as the absence of complications that interfered with the final outcomes(AU)

A 9-year retrospective evaluation of 102 pressure ulcer reconstructions.

OBJECTIVE: Several pressure ulcer (PU) risk factors including paralysis and age greater than 70 have been identified, while others such as nutrition are debated. The object of this study is to identify perioperative risk factors that may predict improved outcomes and reduced complications in primary and recurrent PU reconstructions. METHOD: A retrospective chart review of patients treated surgically for PUs from 2004 to 2013 at the University of Toledo Medical Center, Toledo, Ohio, US, was completed. Data collected included ulcer and medical history, as well as risk factors, complications and postoperative outcome. Data were statistically analysed for perioperative variances between primary and recurrent ulcers and closure status. RESULTS: A total of 49 patients with 102 reconstructions were reviewed. Spinal cord injured patients accounted for 90% receiving flap coverage of ulcers. Numerous differences between primary and recurrent ulcers were identified, including ulcer location, patient nutritional status, wound infection, postoperative course and recurrence. Multivariate analysis revealed a flap reconstruction prediction model using creatinine, haematocrit, haemoglobin, and prealbumin that is able to successfully predict closure outcome in 83.6% of cases. CONCLUSION: Many factors play a role in the development, course and treatment of PUs. It is vital to understand the role of patient risk factors in the development of PUs, to direct subsequent management and reconstruction, and to prevent future recurrences. DECLARATION OF INTEREST: The authors have no conflicts of interest to disclose.