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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 Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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Europa Medicophysica 2002 September;38(3):139-46

language: English

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


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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.

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