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[Treatment of decubitus ulcer using a synthetic skin substitute].

Due to the loss of topesthesia and to the impairment of the vasomotorium in the paralyzed area, patients suffering from tetraplegia have a high risk from pressure sores. Bed sores respond successfully to therapy if, on observing the relevant basic nursing procedure--requiring in particular that the damaged areas of skin be consistently relieved from pressure by means of special positioning of the patient--the sores are subjected to intensive cleansing via surgical and/or enzymatic débridement, and are conditioned with the synthetic skin substitute Epigard. This is achieved as a result of therapeutic procedure followed in a series of methodical steps. Specific treatment with antibiotics before conditioning the wounds supplements these measures and facilitates the spontaneous healing of the lesions or, in the case of larger bed sores, the optimal preparation of the wound bed prior to skin grafting and plastic surgery.

Fluorocarbon Polymers↗

[Costs and long-term results of plastic surgery treatment of decubitus ulcers in paraplegic patients].

Costs and long-term results of plastic surgical procedures were evaluated in 17 paraplegics with a mean age of 39 years and Campbell-Grade 5 pressure sores. Seven sacral, nine ischial and one trochanteric ulcers were treated by myocutaneous or fasciocutaneous flaps. The mean hospitalization period was 82 days: up to 44 days in the plastic surgical department, 29 days in referring hospitals. During the follow-up period, averaging 18 (6 to 33) months, four patients suffered recurrences, all of them ischial sores. Evaluated regarding occupational resumption or duration of wheelchair mobility, eleven patients achieved full and two patients partial rehabilitation. The success rate justifies the operative procedures. Cost reduction by shortened hospitalization could be achieved through earlier transfer of patients to specialized units since preoperative preparation requires rarely more than one week and surgical relief can usually be achieved within a confined period of time. Orthopaedic deformities contributed to the majority of sores and to all recurrences.

Adult↗