# Management of Pressure Sore at Tertiary Care Center in Western Nepal: An Observational Study

## TL;DR

This study examines the characteristics and treatment of pressure sores in a hospital in western Nepal, finding that middle-aged males with spinal injuries often have severe wounds treated with local flaps.

## Contribution

The study provides insights into the clinical profile and management of pressure sores in a regional referral center in Nepal.

## Key findings

- Most patients were middle-aged males with spinal cord injuries and advanced-stage pressure sores.
- Local flap surgery was the most common treatment method for wound reconstruction.
- The majority of wounds were located in the sacral and trochanteric regions.

## Abstract

Pressure sore are localized skin and soft tissue damage typically occurring over bony prominences due to impaired blood supply from sustained pressure. This study aims to review the clinical profile of patients with pressure sore and the type of management of pressure sore in regional referral center of western Nepal.

This retrospective, observational study was conducted at the Department of Burns, Plastic and Reconstructive Surgery, Charak Memorial Hospital, Pokhara, from January 2023 to December 2024. Ethical approval was obtained from National Health Research Council on 16 February 2025 (Reference no:1839). The study included all patients regardless of age and gender who were treated for pressure sores during the study period, with complete medical records. Patient demographics, sore characteristics, predisposing factors, and treatment modalities were analyzed.

There were 21 patients with 42 pressure sore wounds, included with mean age 45.14±25.54 years (range: 16-92 years). Of all patients 16 (79.19%) were male and 16 patients (76.19%) were patients from outside Pokhara Valley. Spinal cord injury was present in 12 (57.14%) patients. The sacral and trochanteric regions were affected with 14 (33.33%) wounds each. There were 26 (61.90%) wounds classified as National Pressure Ulcer Advisory Panel Stage IV. Surgical management was performed in 14 (66.67%) patients with Local flap was used to reconstruct 12 (50%) of the wounds.

Pressure sore in this population predominantly affected middle-aged males with spinal cord injuries, presenting with advanced-stage wounds. Local pattern flap was the most common method of soft tissue coverage.