[Clinical typing and surgical principle of pressure sore].

OBJECTIVE

To investigate the clinical typing and their relevant surgical treatment principle and method of pressure sore.

METHODS

From January 1983 to April 2006, 122 patients with 179 pressure sores were treated. There were 93 males and 29 females, aging 15-68 years. The pressure sores were located at sacrococcygeus (54 lesions), petrochanteric region (37 lesions), ischial tuberosity (30 lesions), heel (17 lesions), olecranon (15 lesions), scapula (9 lesions), lateral malleolar (7 lesions), caput fibulace (4 lesions), pretibial (3 lesions), and lumbar region (3 lesims) respectivly. The disease course was from 2 months to 11 years. The areas of pressure sores were from 1.5 cm x 1.0 cm to 20.0 cm x 18.0 cm. According to the wound characteristics, the pressure sores were divided into three types: sinus type (12/179), ulcer type (74/179) and mixed type (93/179). Aimed at different types of pressure sore, skin grafting, skin flap and myocutaneous flap were employed to repair wound. The areas of flaps were from 5.0 cm x 3.5 cm to 26.0 cm x 14.5 cm. The areas of skin grafting were from 7 cm x 5 cm to 23 cm x 12 cm.

RESULTS

All wounds of sinus type healed by first intention except one; and all flaps survived. All wounds of uler type healed by first intention; and the flaps survived completely except two which had a partial necrosis. All flaps which harvested to repair 93 pressure sores of mixed type were survived. But one or two sinus occurred in 8 cases. Two healed by operation, and the others healed by dressing exchange. The wounds healed by first intention. The donor sites healed by first intention. The routine follow-up in 73 patients after 6 months showed that the recurrence appeared in 4 mixed type. The recurrence rate was 5.5% and the other patients had good outcome.

CONCLUSION

Clinical typing of pressure sore is helpful to select the suitable operation method and improve the rate of success.