Employment of Flap Surgery in Pressure Ulcers Surgical Treatment

Česká verze

Authors: A. Hokynková ¹; P. Šín ¹; F. Černoch ¹; M. Nováková ²; P. Babula ²
Authors place of work: Klinika popálenin a rekonstrukční chirurgie LF MU a FN Brno ¹; Fyziologický ústav, LF MU, Brno ²
Published in the journal: Cesk Slov Neurol N 2017; 80(Supplementum 1): 41-44
Category: Původní práce
doi: https://doi.org/10.14735/amcsnn2017S41

Summary

Aim:
Aim of the paper is to describe surgical treatment of pressure ulcers, which includes primarily careful necrectomy with complete extirpation of ulcer’s pseudocyst, removing of fistulas and eventual resection of osteolytic or osteomyelitic centre.

Material and methods:
This case report presents surgical procedure of pressure ulcer treatment, including photo documentation, in a paraplegic patient (born 1974) with pressure ulcer treated by flap surgery.

Conclusion:
Surgical treatment of pressure ulcer requires multidisciplinary approach, especially at the treatment onset. Type as well as timing of flap surgery is planned individually according to patient’s commorbidities, based on size, depth and localisation of defect. Antidecubital prevention in all phases of treatment – before, during and after the surgery – significantly decreases risk of acute and late complications and pressure ulcers recurrence.

Key words:
necrectomy – pressure ulcer – flap surgery – treatment

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Zdroje

1. European Press ure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Treatment of pres sure ulcers: Quick Reference Guide. Washington DC: National Pres sure Ulcer Advisory Panel 2009.

2. Pokorná A, Benešová K, Mužík J, et al. Sledování dekubitálních lézí u pacientů s neurologickým onemocněním – analýza Národního registru hospitalizovaných. Cesk Slov Neurol N 2016;79/ 112(Suppl 1):S8– 14. doi: 10.14735/ amcsnn2016S14.

3. Haesler E, ed. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan PaciﬁcPressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Perth, Australia: Cambridge Media 2014.

4. Stryja J. Význam a možnosti chirurgického débridementu dekubitů. Cesk Slov Neurol N 2016;79/ 112(Suppl 1):S25– 7. doi: 10.14735/ amcsnn2016S25.

5. Hokynková A, Fiamoli M, Černoch F. Operační léčba dekubitů. Geriatrie a Gerontologie 2014;3(3):123– 7.

6. Siegel JD, Rhinehart E, Jackson M, et al, the Healthcare Infection Control Practices Advisory Committee Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings, June 2007. [online]. Available from URL: http:/ / www.cdc.gov/ ncidod/ dhqp/ pdf/ guidelines/ Isolation2007.pdf.

7. Riebelová V, Válka J, Franců M. Trendy soudobé chirurgie. Dekubity. Praha: Galén 2000.

8. Thiessen FE, Andrades P, Blondeel P, et al. Flap surgery for pressure sores: Should the underlying muscle be transferred or not? J Plast Reconstr Aesthet Surg 2011;64(1):84– 90. doi: 10.1016/ j.bjps.2010.03.049.

9. Bauer J, Phillips LG. MOC-PSSM CME article: Pressure sores. Plast Reconstr Surg 2008;121(Suppl 1):1– 10. doi: 10.1097/ 01.prs.0000294671.05159.27.

10. Franců M, Hodová S, et al. Perioperační péče o pacienta v rekonstrukční chirurgii a léčbě popálenin, Brno: NCONZO 2011:125– 32.

11. Hurbungs A, Ramkalawan H. Sacral pressure sore reconstruction: the pedicled superior gluteal artery perforator flap. S Afr J Surg 2012;50(1):6– 8.

12. Lin H, Hou C, Chen A, et al. Long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores. J Reconstr Microsurg 2010;26(6):355– 8. doi: 10.1055/ s-0030-1249318.

13. Bertheuil N, Huguier V, Aillet S, et al. Biceps femoris ﬂap for closure of ischial pressure ulcers. Eur J Plast Surg 2013;6(10):639– 44. doi: 10.1007/ s00238-013-0862-z.

14. Vašíčková L, Sieglová J, Mašek M. Význam tlakové mapy (pressure mapping system) pro pacienty s mobilitou na vozíku. Cesk Slov Neurol N 2016;79/ 112(Suppl 1): S15– 9. doi: 10.14735/ amcsnn2016S15.