The Surgical Treatment of Pressure Ulcers in the Patient with Spinal Injuries

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.

Download Full-text

NONCOMPLICATED UNSTABLE SPINE INJURIES IN CHILDREN

Hirurgiâ pozvonočnika ◽

10.14531/ss2005.2.8-12 ◽

2005 ◽

pp. 008-012 ◽

Cited By ~ 1

Author(s):

Eduard Vladimirovich Ulrikh ◽

Sergey Valentinivich Vissarionov ◽

Aleksandr Yuryevich Mushkin

Keyword(s):

Surgical Treatment ◽

Posterior Instrumentation ◽

Spinal Injuries ◽

Anterior Decompression ◽

Two Stage ◽

Spinal Stabilization ◽

Spine Injuries ◽

Group A ◽

Bone Autograft

Thirty-four patients aged from 3 to 17 years were operated on for noncomplicated unstable injuries of the spine. The operation was performed within the next few hours or days after trauma in 15 cases and significantly later (in 2 to 6 months) in 19 cases. In the first group the surgery included indirect posterior instrumental reduction and stabilization of the spine. In the second group a two-stage surgery was performed simultaneously. The first stage included anterior decompression and stabilization, and the second – posterior instrumentation. In both groups the posterior fusion with bone autograft was done. The post-op follow-up was 5 years. The correction of deformity, spinal stabilization and pain arrest were achieved in all cases. The surgical treatment of unstable noncomplicated spinal injuries in children must be conducted by emergency indications within the first hours and days after trauma.

Download Full-text

Treatment of Injuries of the Lumbar Spine

Bulletin of Science and Practice ◽

10.33619/2414-2948/49/15 ◽

2019 ◽

Vol 5 (12) ◽

pp. 156-162

Author(s):

M. Sabyraliev

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Spinal Canal ◽

Thoracolumbar Spine ◽

Spinal Injuries ◽

Long Term Results ◽

Results Of Treatment ◽

Post Traumatic

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).

Download Full-text

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.

Download Full-text