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EVALUATION OF CLINICAL PROFILE AND SURGICAL MANAGEMENT OUTCOMES OF POST TRAUMATIC PRESSURE ULCERS LOCATED AT VARIOUS ANATOMICAL SITES IN PARAPLEGICS PATIENTS ADMITTED TO A TERTIARY CARE HOSPITAL.
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Background: Pressure ulcers are a chronic, debilitating complication primarily affecting immobilized patients, especially those with paraplegia.
These lesions commonly occur over bony prominences such as the sacrum, trochanter, and ischium, and their management often necessitates
surgical reconstruction in advanced stages. This study evaluates the clinical profile and surgical ou Objective: tcomes of pressure ulcers located at
various anatomical sites among paraplegic patients admitted to a tertiary care hospital, aiming to identify optimal reconstructive techniques and
minimize postoperative complications. A prospective observational study was conducted on 64 patients Methods: with Stage III and IV pressure
ulcers. Clinical data including age, sex, ulcer size, location, staging, nutritional status, hemoglobin levels, and presence of infection were recorded.
Surgical procedures performed included fasciocutaneous, musculocutaneous, and perforator-based flaps. Postoperative outcomes, including
complications, recurrence rates, and flap survival, were analyzed. The sacral (48.4%) and trochanteri Results: c (42.2%) regions were the most
commonly affected sites. Most patients were male (70.3%) and aged 15–45 years. Low serum albumin (<3 g/dL) and anemia (<10 g/dL) were
observed in 56.2% and 60.9% of patients, respectively, with albumin levels showing a significant association with postoperative infections (p =
0.012). Fasciocutaneous rotational flaps for sacral ulcers demonstrated the lowest complication and recurrence rates (16.7%) compared to gluteus
maximus flaps. Trochanteric ulcers were effectively managed using tensor fascia lata (TFL) V-Y advancement flaps, while ischial ulcers showed
favourable outcomes with posterior thigh flaps. Surgical reconstruction, particularly using Fasciocut Conclusion: aneous and TFL V-Y
advancement flaps, provides favourable outcomes for advanced pressure ulcers. Preoperative optimization of nutritional and haematological
status, along with flap selection based on ulcer characteristics and anatomical location, is essential to minimize complications and recurrence. A
multidisciplinary approach significantly enhances recovery and rehabilitation.
World Wide Journals
Title: EVALUATION OF CLINICAL PROFILE AND SURGICAL MANAGEMENT OUTCOMES OF POST TRAUMATIC PRESSURE ULCERS LOCATED AT VARIOUS ANATOMICAL SITES IN PARAPLEGICS PATIENTS ADMITTED TO A TERTIARY CARE HOSPITAL.
Description:
Background: Pressure ulcers are a chronic, debilitating complication primarily affecting immobilized patients, especially those with paraplegia.
These lesions commonly occur over bony prominences such as the sacrum, trochanter, and ischium, and their management often necessitates
surgical reconstruction in advanced stages.
This study evaluates the clinical profile and surgical ou Objective: tcomes of pressure ulcers located at
various anatomical sites among paraplegic patients admitted to a tertiary care hospital, aiming to identify optimal reconstructive techniques and
minimize postoperative complications.
A prospective observational study was conducted on 64 patients Methods: with Stage III and IV pressure
ulcers.
Clinical data including age, sex, ulcer size, location, staging, nutritional status, hemoglobin levels, and presence of infection were recorded.
Surgical procedures performed included fasciocutaneous, musculocutaneous, and perforator-based flaps.
Postoperative outcomes, including
complications, recurrence rates, and flap survival, were analyzed.
The sacral (48.
4%) and trochanteri Results: c (42.
2%) regions were the most
commonly affected sites.
Most patients were male (70.
3%) and aged 15–45 years.
Low serum albumin (<3 g/dL) and anemia (<10 g/dL) were
observed in 56.
2% and 60.
9% of patients, respectively, with albumin levels showing a significant association with postoperative infections (p =
0.
012).
Fasciocutaneous rotational flaps for sacral ulcers demonstrated the lowest complication and recurrence rates (16.
7%) compared to gluteus
maximus flaps.
Trochanteric ulcers were effectively managed using tensor fascia lata (TFL) V-Y advancement flaps, while ischial ulcers showed
favourable outcomes with posterior thigh flaps.
Surgical reconstruction, particularly using Fasciocut Conclusion: aneous and TFL V-Y
advancement flaps, provides favourable outcomes for advanced pressure ulcers.
Preoperative optimization of nutritional and haematological
status, along with flap selection based on ulcer characteristics and anatomical location, is essential to minimize complications and recurrence.
A
multidisciplinary approach significantly enhances recovery and rehabilitation.
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