Retrospective analysis of stage IV pressure injuries managed without operative closure in veterans admitted to a spinal cord injuries/disorders unit.

Abstract

Objective: Patients with spinal cord injuries/disorders (SCI/D) have one of the highest risks of developing pressure injuries, but surgical closure of these wounds has significant pre-operative and post-operative requirements with a high rate of complications. Limited data exists on the outcomes of stage IV pressure injuries that are not managed with surgical closure. Our objective was to review outcomes of patients with stage IV pressure injuries that close by secondary intention.

Design: Retrospective case series review Setting: Veterans Affairs hospital.

Methods: Records of veterans hospitalized on an SCI/D inpatient unit during March 2022 to June 2023 were reviewed to determine if patients were admitted with a stage IV pressure injury. These charts were then further reviewed to determine wound characteristics, medical and surgical management, and wound outcomes.

Results: Charts of twenty-three Veterans with a total of 25 pressure injuries were reviewed.

Conclusions: Ninety-two percent of stage IV pressure injuries improved with complete healing in 36%, though over half of these wounds had imaging concerning for osteomyelitis and required surgical debridement and/or antibiotics. Additionally, these wounds improved or closed though 91.30% were prescribed a progressive sitting program.