Complications and their associations following the surgical repair of pressure ulcers

Am J Surg. 2018 Dec;216(6):1177-1181. doi: 10.1016/j.amjsurg.2018.01.012. Epub 2018 Jan 31.

Abstract

Background: Despite high expenditure, there is little national data on rates of complications following pressure ulcer repair. Complications, mortality and their predictors following surgical repair of pressure ulcers were evaluated.

Methods: Patients undergoing pressure ulcer repair were identified in the NSQIP database from 2005 to 2015. Regression models were used to identify risk factors for complications.

Results: 1248 cases were identified with a complication rate of 35.0%. Obesity was associated with increased risk of complications, whereas flap closure was associated with fewer complications. Thirty-day mortality was 3.3%. Elderly age and diabetes were associated with increased mortality.

Conclusions: Elderly age, diabetes and dependency are associated with increased mortality following pressure ulcer surgery. Flap repair is associated with decreased complications. Pressure ulcer reconstruction requires careful patient selection and surgical technique to mitigate risks and mortality.

Keywords: Complications; Flap surgery; NSQIP; Outcomes; Pressure ulcers.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / adverse effects*
  • Postoperative Complications / epidemiology*
  • Pressure Ulcer / complications*
  • Pressure Ulcer / mortality
  • Pressure Ulcer / surgery*
  • Retrospective Studies
  • Risk Factors
  • Surgical Flaps*
  • Survival Rate
  • Treatment Outcome