Evaluating the efficacy of vascularized pedicled skin flaps in treating sacrococcygeal pressure ulcers

TL;DR

This study examines the effectiveness of vascularized pedicled skin flaps in treating sacrococcygeal pressure ulcers and identifies factors influencing treatment outcomes.

Contribution

The study provides insights into the effectiveness of vascularized pedicled skin flaps and emphasizes individualized flap selection for optimal results.

Findings

Favorable outcomes were observed in 80.9% of cases at 2 weeks and 83.3% at 1 month post-surgery.

Ulcer size, flap dimensions, and postoperative hospitalization duration were key factors influencing outcomes.

The study supports a tailored, experience-based approach rather than a one-size-fits-all flap type.

Abstract

Pressure ulcers, particularly sacrococcygeal ulcers, represent a persistent healthcare challenge despite being preventable. This study aims to evaluate the outcomes of using vascularized pedicled skin flaps for sacrococcygeal pressure ulcer treatment and to identify factors influencing these outcomes at our hospital.

A descriptive case series study was conducted on 42 patients with sacrococcygeal pressure ulcers treated using pedicled skin flaps with preserved vascular supply from May 2018 to May 2023.

The study population had a female-to-male ratio of 6:4, with a mean age of 72.5 years (range: 27–97 years). A majority (61.9 %) of patients received weight-bearing flaps. Favorable outcomes were observed in 34 cases (80.9 %) at 2 weeks and in 35 cases (83.3 %) at 1 month post-surgery. Key factors influencing outcomes included ulcer size, flap dimensions, and the duration of postoperative hospitalization.

Pedicled flap reconstruction remains effective for sacrococcygeal pressure ulcer management. Flap selection should be individualized, taking into account ulcer size, patient mobility, and surgical goals. While outcomes varied across flap types, this study supports a tailored, experience-based approach rather than asserting one flap's superiority. Further comparative research is warranted.

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