In patients with paraplegia, the continued presence of a pressure sore is usually the most important factor delaying rehabilitation.
The cause of a pressure sore is exactly what its name implies-pressure, and the patient most likely to develop pressure sores are patients who have loss of skin sensation and comatose condition due to spinal cord injury, cerebral vascular accident or CO intoxication. Emaciated patients with prominent bony prominences, and patients with metabolic protein disturbances also are likely candidates.
In the care of the ulcer, the underlying physical, metabolic and neurovascular etiologicfactors are corrected insofar as possible. The purpose of definitive surgery is to remove the ulcer, its contents, surrounding unsatisfactory tissues, infected bursae and thee underlying, often devitalized, bony prominence, "en bloc" if possible.
Authors report nine pressure sores in seven patients of spinal cord injury and CO´ intoxication which.have been satisfactorily treated by large good padding local flap coverage or split thickness skin graft for the defects following removal of the ulcers including surrounding scar tissue and underlying bony prominence in Department of Plastic Surgery in St. Mary´s Hospital, and brief review of references on pressure sore
followed.
|