A 9-year retrospective evaluation of 102 pressure ulcer reconstructions

Kenneweg, K A; Welch, Marlene; Welch, Philip

doi:10.12968/jowc.2015.24.sup4a.s12

Cited by 14 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ulcer recurrence and wound dehiscence are the most common surgical complications with recurrence rates as high as 80% in some series. 12 , 13 , 16 , 17 , 19 – 21 The wide variation in reported outcomes suggests that patient-specific risk factors should be investigated further to determine the optimal operative settings. We hypothesized that there are patient-specific and potentially modifiable risk factors associated with complications after flap reconstruction for pressure ulcers.…”

Section: Introductionmentioning

confidence: 99%

Flap Reconstruction for Pressure Ulcers: An Outcomes Analysis

Bamba

Madden

Hoffman

et al. 2017

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:Historically, complication rates after pressure ulcer reconstruction utilizing flap coverage have been high. Patients undergoing operations for pressure ulcer coverage typically have multiple risk factors for postoperative complications. The purpose of this study was to examine a large patient series in the pressure ulcer population to uncover objective evidence of the linkage between risk factors and outcomes after flap coverage.Methods:This study was a retrospective chart review of patients who underwent flap reconstruction for a pressure ulcer between 1997 and 2015. The characteristics of patients were analyzed to determine those who had complications such as pressure ulcer recurrence, wound dehiscence, and wound infection.Results:All patients (N = 276) underwent flap coverage of their pressure ulcers. The overall complication rate was 58.7% (162 patients). Wound dehiscence was the most common complication (31.2%), and the pressure ulcer recurrence rate was 28.6%. Multivariate regression for pressure ulcer recurrence revealed that body mass index <18.5 [relative risk (RR) 3.13], active smoking (RR 2.33), and ischial pressure ulcers (RR 3.46) were independent risk factors for pressure ulcer recurrence. Ischial pressure ulcers (RR 2.27) and preoperative osteomyelitis (RR 2.78) were independent risk factors for wound dehiscence. Diabetes was an independent risk factor for wound infection (RR 4.34).Conclusions:Our retrospective analysis revealed numerous factors that are associated with high rates of major postoperative complications. Risk factors must be taken into account when offering flap coverage, and risk-reducing strategies must be implemented in patients before pressure ulcer reconstruction.

show abstract

Section: Introductionmentioning

confidence: 99%

Flap Reconstruction for Pressure Ulcers: An Outcomes Analysis

Bamba

Madden

Hoffman

et al. 2017

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…In the other prediction models constructed in this study, haemoglobin emerged as an influential factor in addition to HCT and RBC. Low HCT and haemoglobin levels indicate anaemia, a chronic disease that almost certainly contributes to delayed wound healing in PI (Kenneweg et al, 2015). For example, a retrospective cohort study by Takahashi et al (2009) showed that the number of wounds and haemoglobin levels remained significant predictors of healing status in adults with chronic wounds.…”

Section: Discussionmentioning

confidence: 99%

A model for predicting 7‐day pressure injury outcomes in paediatric patients: A machine learning approach

Xiao

Pan

Lin

et al. 2020

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aims We sought to explore factors associated with early pressure injury progression and build a model for predicting these outcomes using a machine learning approach. Design A retrospective cohort study. Methods In this study, we recruited paediatric patients, with hospital‐acquired stage I pressure injury or suspected deep tissue injury, who met the inclusion criteria between 1 January 2015–31 October 2018. We divided patients into two groups, namely healing or delayed healing, then followed them up for 7 days. We analysed patient pressure injury characteristics, demographics, treatment, clinical situation, vital signs, and blood test results, then build prediction models using the Random Forest and eXtreme Gradient Boosting approaches. Results The best prediction model, trained and tested using Random Forest with 10 variables, achieved an accuracy, sensitivity, specificity, and area under the curve of 0.82 (SD 0.06), 0.80 (SD 0.08), 0.84 (SD 0.08), and 0.89 (SD 0.06), respectively. The most contributing variables, in order of importance, included serum creatinine, red blood cell, and haematocrit. Conclusion An awareness of specific conditions and areas that could lead to delayed healing pressure injury in paediatric patients is needed. Impact This evidence‐based prediction model, coupled with the aforementioned clinical indicators, is expected to enhance early prediction of outcomes in paediatric patients thereby improve the quality of care and the outcome of children with PIs.

show abstract

“…Hypoalbuminemia is traditionally associated with poor nutritional status and subsequent high incidence of postoperative complications, including wound dehiscence and ulcer recurrence. 32 Recent evidence has shown that this nutritional marker alone is inadequate as an independent predictor of complications in pressure sore patients. 33 Serum albumin levels may be affected only in those experiencing “extreme” starvation (defined as a body mass index <12 kg/m 2 ) or greater than 6 weeks’ starvation.…”

Section: Methodsmentioning

confidence: 99%

SPINE: An Initiative to Reduce Pressure Sore Recurrence

Brown

Hassanein

Gabriel

et al. 2022

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

The recurrence rate after pressure sore reconstruction remains high. Primary inciting factors can be organized into efforts aimed at wound prevention: spasticity relief, pressure off-loading, infection and contamination prevention, nutrition optimization, and maximizing extremity function. This article presents our detailed protocol, SPINE, to address each inciting factor with a summary of cases at our facility and review best practices from evidence-based medicine in the literature.

show abstract

A 9-year retrospective evaluation of 102 pressure ulcer reconstructions

Abstract: The authors have no conflicts of interest to disclose.

Cited by 14 publications

References 13 publications

Flap Reconstruction for Pressure Ulcers: An Outcomes Analysis

Flap Reconstruction for Pressure Ulcers: An Outcomes Analysis

A model for predicting 7‐day pressure injury outcomes in paediatric patients: A machine learning approach

SPINE: An Initiative to Reduce Pressure Sore Recurrence

Contact Info

Product

Resources

About