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KMID : 0922220100100010033
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Journal of the Korean Musculoskeletal Transplantation Society
2010 Volume.10 No. 1 p.33 ~ p.42
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Comparison of Reconstruction Surgery for the Type IV Pressure Sores between the Paraplegia and the Quadriplegia
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Kee Sung-Chan
Kim Hee-Dong
Kim Dae-Hee
Jeon Sung-Hoon
Choi Yong-Soo
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Abstract
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Purpose: To compare the surgical results of type IV pressure sore in paraplegic and quadriplegic patients and to investigate the preoperative management conducted to obtain successful surgical results.
Materials and Methods: We studied 23 reconstruction surgeries in sixteen patients who had undergone musculocutaneous flap according to the condition of the wounds. We evaluated the preoperative management for successful surgical results and compared the results between paraplegic and quadriplegic patients groups. The mean follow-up period was 19.8 months.
Results: Of 23 cases, 14 showed wound infection and the mean duration of administration of the preoperative antibiotics was 19.6±15.5 days in paraplegic patients group and 17.0±7.8 days in quadriplegic patients group. We determined the surgical timing according to C-reactive protein, which decreased to a mean of 1.4±1.6 g/dl at the time of operation from a mean of 5.9± 8.0 g/dl at the initial admission (p=0.041). Laboratory investigations revealed decreases in the level of hemoglobin and albumin after operations from 11.6±1.4 g/dl to 10.8±1.8 g/dl in hemoglobin (p=0.009) and from 3.4±0.5 g/dl to 3.1±0.6 g/dl in albumin (p=0.016). The level of Creactive protein was higher in paraplegic patients group but those of hemoglobin and albumin were lower. The duration of the administration of antibiotics was longer in paraplegic patients group; 39.5±25.7 days in paraplegic patients group and 31.1±11.7 days in quadriplegic patients group (p=0.014).
Conclusion: To obtain a good result in surgical treatment for type IV pressure sore, it is essential to keep an appropriate wound management and control of acute infection before operation.
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KEYWORD
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Pressure sore, Spinal cord injury, Soft tissue reconstructive surgery
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