What measures should be taken to minimize the risk of adverse outcomes of the reconstruction of pressure injuries (pressure ulcers)?

Updated: Mar 26, 2020
  • Author: Christian N Kirman, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

Treatment of patients with pressure injuries involves several perioperative considerations to minimize the risk of adverse outcomes of the reconstruction, as follows:

  • Preoperatively, patients must be meticulously and compulsively prepared, with nutritional deficiency, anemia, spasms, and coexisting urinary infection corrected; adequate social resources, including pressure-release beds, wheelchair mattresses, and a compliant attitude, should be present
  • Intraoperatively, key technical points must be carefully addressed, including tension-free flap reconstruction, suction catheter drainage, meticulous hemostasis, and aggressive débridement
  • Postoperatively, a strict and careful regimen for the transition from flat bed rest to sitting and for weight-shifting into and out of the wheelchair in the return to daily living must be implemented; pressure-reducing mattresses and pressure-release techniques should be used

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