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Flap Survival after Reconstructive Surgery for Pressure Ulcers: A Cohort Study
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.ORCID iD: 0000-0002-8027-9632
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
2023 (English)In: Plastic and Reconstructive Surgery - Global Open, E-ISSN 2169-7574, Vol. 11, no 12, p. e5451-e5451Article in journal (Refereed) Published
Abstract [en]

Background: Pressure ulcers are troublesome for patients and require considerable resources to resolve. Previous studies have focused on recurrence, whereas there are few studies on flap survival. The aim was to describe the group and to analyze possible factors for flap survival.

Method: A descriptive retrospective analysis of all operations between 2008 and 2020 was carried out. Flap survival at 40 days was assessed. A flap was classified as a failure if a reoperation with removal or replacement was planned before, or in connection with, the first return visit. Variables of patient demographics, details of the pressure ulcers, and surgical treatment and care were analyzed with multivariable logistic regression for their effect on flap survival.

Results: A total of 111 flaps were included [78 (70%) with random blood supply and 33 (30%) with axial or perforator-based blood supply]; 54 (49%) of the flaps were fasciocutaneous. Body mass index was 25 (IQR 22–28). Flap survival rate was 90%. Variables associated with flap failure were higher body mass index, congenital spinal cord injury, type of blood supply to the flap, and the use of methylene blue to guide debridement of the wound.

Conclusions: The findings show factors that can be modified to improve future results, including a normalized body mass index and use of methylene blue in surgery to outline wound edges and depth, as this has been shown to protect against flap failure. Our data suggest that random flaps, such as V-Y, are preferable to axial flaps in the studied group.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2023. Vol. 11, no 12, p. e5451-e5451
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Surgery
Identifiers
URN: urn:nbn:se:liu:diva-199650DOI: 10.1097/gox.0000000000005451ISI: 001125354000008PubMedID: 38098948OAI: oai:DiVA.org:liu-199650DiVA, id: diva2:1819929
Available from: 2023-12-15 Created: 2023-12-15 Last updated: 2024-02-09Bibliographically approved

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Nööjd, MariWyckman, AlexanderSteinvall, IngridElmasry, Moustafa

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Nööjd, MariWyckman, AlexanderSteinvall, IngridElmasry, Moustafa
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Hand and Plastic Surgery
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Plastic and Reconstructive Surgery - Global Open
Surgery

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