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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Europa Medicophysica 2002 September;38(3):139-46
Treatment of decubitus ulcers in patients with spina bifida
Bocchi A., Traspassi S., Bianco G., Castagnetti F., Papadia F.
Chair of Plastic and Reconstructive Surgery, University of Parma, Parma
Background. Decubitus ulcers always confer significant morbidity to patients. On the one hand it represents a serious hurdle to orthopedic surgery and the use of splints, while on the other, it is often complicated by infection and poor nutritional state. Surgically, the management of pressure sores involves not only debridement and reconstructive procedures using highly-vital tissues (fasciocutaneous flaps and myocutaneous flaps), but also incorporates pre- and postoperative devices, such as hyperbaric oxygen-therapy and anti-decubitus beds.
Methods. We report our experience with 52 patients treated for decubitus ulcers, of which 20 received reconstructive surgery, from January 1994 to December 2001.
Results. Four factors allowed us to obtain optimum results with very low recurrence rates: 1) a careful wound bed preparation phase, 2) hyperbaric oxygen therapy when indicated (chronic wounds), 3) the use of anti-decubitus beds for 15 days and 4) the absence of mechanical load on the area at least for 40 postoperative days.
Conclusions. Finally, we stress the importance of decubitus prevention which focuses on early recognition of trophic damage.