Disparities in pressure ulcer flap reconstruction associated with barriers to accessing postoperative care.

IF 1.7 4区医学 Q3 DERMATOLOGY

Journal of wound care Pub Date : 2025-12-01 DOI:10.12968/jowc.2022.0172

Peter M Vonu, Michael Ali, Rachel H Safeek, Rolando Otero, Sarah Virk, Harvey Chim, Ellen S Satteson

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引用次数: 0

Abstract

Background: Flap reconstruction for pressure ulcers remains a surgical challenge, requiring careful selection of suitable patients to optimise outcomes. Postoperative care, especially pressure offloading, is critical for the prevention of complications, which include failure of the skin flap and wound recurrence. While the rates and risks of postoperative complications have been acknowledged, the challenges of postoperative care have been largely unaddressed.

Method: A 10-year retrospective review of all patients undergoing flap reconstruction for pressure ulcers at the College of Medicine (University of Florida, Florida, US) was conducted to elucidate factors that affected delays to discharge, post-discharge disposition (where the patient is discharged to), postoperative care and associated complications.

Results: Among patients who underwent multiple separate reconstructions, disposition to home versus a skilled nursing facility (SNF) or long-term acute care hospital (LTACH) had a significant association with a higher risk of complications.

Conclusion: In these high-risk patients, a multidisciplinary approach that would ideally be put in place preoperatively should be used to optimise postoperative care and prevent unnecessary prolonged hospitalisation.

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压疮皮瓣重建的差异与获得术后护理的障碍有关。

背景：压疮皮瓣重建仍然是一个外科挑战，需要仔细选择合适的患者来优化结果。术后护理，特别是减压，是预防并发症的关键，包括皮瓣失败和伤口复发。虽然术后并发症的发生率和风险已经得到承认，但术后护理的挑战在很大程度上尚未得到解决。方法：对美国佛罗里达大学医学院（University of Florida, Florida， US）所有因压力性溃疡接受皮瓣重建的患者进行10年回顾性分析，以阐明影响延迟出院、出院后处置（患者出院的地方）、术后护理和相关并发症的因素。结果：在接受多次单独重建的患者中，倾向于家庭而不是专业护理机构（SNF）或长期急性护理医院（LTACH）与更高的并发症风险显著相关。结论：对于这些高危患者，术前应采用多学科方法优化术后护理，防止不必要的延长住院时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.