Comparative study between fasciocutaneous and myocutaneous flaps in the surgical treatment of pressure ulcers of the sacral region

The aim of this study was to evaluate morphological characteristics of pressure ulcers, methods of surgical treatment and its effectiveness in the Clinic of Plastic and Reconstructive Surgery of Kaunas University of Medicine Hospital. Material and methods. A retrospective data analysis of 139 patients with pressure ulcers treated in the Clinic of Plastic and Reconstructive Surgery, Kaunas University of Medicine Hospital, from January 1996 to January 2007 was performed. Results. A total of 139 patients were surgically treated for pressure ulcers at the Clinic of Plastic and Reconstructive Surgery, Kaunas University of Medicine Hospital, from January 1996 to January 2007. Eighty-one patients were treated repeatedly (from 1 to 7 admissions; M=1). Pressure ulcers were healed completely in 94 patients who underwent surgery during the treatment in the hospital; in 45 patients who underwent surgical treatment, pressure ulcers were partially healed, and on discharge from hospital, only small wounds were left. Pressure ulcers most commonly occur in tuber ischii area (69 cases). The mean age of patients was 42±13.65 years (M=31); pressure ulcers were for 8.9±8.5 months on average (M=31). At admission to Kaunas University of Medicine Hospital, the mean size of pressure ulcers was 42.62±53.27 cm2 (M=10). The results showed that the size of pressure ulcers depends on the duration of paraplegia (P<0.05). In 93 cases, pressure ulcers were treated using myocutaneous flaps; 17 of them were closed with V-Y advancement technique over the sacral area, 35 were closed with m. gluteus rotation flap, and in 41 cases, V-Y advancement technique using hamstring flaps was used. Conclusions. In patients with paraplegia, the first pressure ulcer occurs after 74.79±61.34 months from the onset of the disease. Pressure ulcers most commonly occur over tuber ischii area. The most effective surgical treatment of pressure ulcers is closure of the wound using myocutaneous flaps (use of the hamstrings); fasciocutaneous flaps were the most commonly used method in patients who underwent surgery for the second time.

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PREDICTIVE FACTORS IN THE CHOICE OF SURGICAL TREATMENT FOR COLORECTAL CANCER WITH LAPAROSCOPIC OR "OPEN" ACCESS

Problems in oncology ◽

10.37469/0507-3758-2017-63-3-470-474 ◽

2017 ◽

Vol 63 (3) ◽

pp. 470-474

Author(s):

Rustem Topuzov ◽

Georgiy Manikhas ◽

Eskender Topuzov ◽

Mikhail Khanevich ◽

Magomed Abdulaev ◽

...

Keyword(s):

Colorectal Cancer ◽

Surgical Treatment ◽

Postoperative Complications ◽

Open Access ◽

Comparative Study ◽

Retrospective Analysis ◽

Predictive Factors

There are presented results of surgical treatment of 347 patients with colorectal cancer. Based on the retrospective analysis a comparative study of results of surgical treatment for colorectal cancer using laparoscopic technologies and “open” access was carried out. Predictive factors that correlate with the risk of postoperative complications with laparoscopic and “open” access at the surgical stage of treatment for colorectal cancer were determined.

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Quality of life in women with vulvar cancer submitted to surgical treatment: a comparative study

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2012.06.027 ◽

2012 ◽

Vol 165 (1) ◽

pp. 91-95 ◽

Cited By ~ 26

Author(s):

Ana Paula de Melo Ferreira ◽

Elyonara Mello de Figueiredo ◽

Renilton Aires Lima ◽

Eduardo Batista Cândido ◽

Marilene Vale de Castro Monteiro ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Comparative Study ◽

Vulvar Cancer

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Mesenchymal Stem Cells and Transforming Growth Factor-β3 (TGF-β3) to Enhance the Regenerative Ability of an Albumin Scaffold in Full Thickness Wound Healing

Journal of Functional Biomaterials ◽

10.3390/jfb9040065 ◽

2018 ◽

Vol 9 (4) ◽

pp. 65 ◽

Cited By ~ 4

Author(s):

Dale Feldman ◽

John McCauley

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Surgical Treatment ◽

Growth Factor ◽

Healing Rate ◽

Pressure Ulcers ◽

Transforming Growth Factor ◽

Bed Rest ◽

Full Thickness ◽

Non Surgical Treatment

Pressure ulcers are one of the most common forms of skin injury, particularly in the spinal cord injured (SCI). Pressure ulcers are difficult to heal in this population requiring at least six months of bed rest. Surgical treatment (grafting) is the fastest recovery time, but it still requires six weeks of bed rest plus significant additional costs and a high recurrence rate. A significant clinical benefit would be obtained by speeding the healing rate of a non-surgical treatment to close to that of surgical treatment (approximately doubling of healing rate). Current non-surgical treatment is mostly inactive wound coverings. The goal of this project was to look at the feasibility of doubling the healing rate of a full-thickness defect using combinations of three treatments, for the first time, each shown to increase healing rate: application of transforming growth factor-β3 (TGF-β3), an albumin based scaffold, and mesenchymal stem cells (MSCs). At one week following surgery, the combined treatment showed the greatest increase in healing rate, particularly for the epithelialization rate. Although the target level of a 100% increase in healing rate over the control was not quite achieved, it is anticipated that the goal would be met with further optimization of the treatment.

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Clinical Outcomes of Spontaneous Spinal Epidural Hematoma : A Comparative Study between Conservative and Surgical Treatment

Journal of Korean Neurosurgical Society ◽

10.3340/jkns.2012.52.6.523 ◽

2012 ◽

Vol 52 (6) ◽

pp. 523 ◽

Cited By ~ 25

Author(s):

Tackeun Kim ◽

Chang-Hyun Lee ◽

Seung-Jae Hyun ◽

Sang Hoon Yoon ◽

Ki-Jeong Kim ◽

...

Keyword(s):

Surgical Treatment ◽

Comparative Study ◽

Clinical Outcomes ◽

Epidural Hematoma ◽

Spinal Epidural Hematoma ◽

Spontaneous Spinal Epidural Hematoma ◽

Conservative And Surgical Treatment ◽

Spinal Epidural

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Analysis of epidemiological characteristics and surgical treatment of patients with pressure ulcer

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh200319093p ◽

2021 ◽

pp. 93-93

Author(s):

Dragana Petrovic-Popovic ◽

Milan Stojicic ◽

Maja Nikolic-Zivanovic

Keyword(s):

Surgical Treatment ◽

Pressure Ulcer ◽

Traffic Accidents ◽

Pressure Ulcers ◽

Stage Iv ◽

Clinical Center ◽

Bony Prominence ◽

The University ◽

Epidemiological Characteristics ◽

Reconstructive Methods

Introduction/Objective. A pressure ulcer is a localized injury to the skin and/or underlying tissue, usually over a bony prominence. It appears as a result of pressure or combination of pressure and shear. Pressure ulcers can be identified within a wide variety of patient subpopulations and a major role in their treatment plays epidemiological and etiological aspects. Methods. A retrospective study of data analysis included 72 patients with pressure ulcers that were hospitalized and surgically treated during a five-year period at the Clinic for Burns, Plastic and Reconstructive Surgery of the University Clinical Center of Serbia in Belgrade. Main data features used in the analysis were: gender, age, principal diseases, comorbidities and biochemical indicators of malnutrition. The patients' data was obtained from the existing patients? records. Additionally, the study analyzed the method of treating pressure ulcers, types of reconstructive methods in surgical treatment, as well as the incidence rate of partial osteotomy. Results. A total of 72 patients with pressure ulcers were included into this study with 54.7 ? 16.1 mean age. Three times more patients injured in traffic accidents were male (75% vs. 25%), while the most of the patients with multiple sclerosis were female (85.7%). More than 95% of patients who had pressure ulcers of III or IV stage were treated surgically with a reconstructive method of transposition or rotation myocutaneous flap. The patient with pressure ulcer of stage IV was usually treated with partial osteotomy. Conclusion. A surgical reconstructive treatment with fasciocutaneous and myocutanaeous flaps represents a gold standard for treating patients with pressure ulcers. These procedures provide reconstruction with adequate flap coverage and obliteration of dead space with well-vascularized tissue but with necessity of further implementation of antidecubitus measures.

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