Biplanar flap reconstruction for pressure ulcers: experience in patients with immobility from chronic spinal cord injuries Journal Article


Authors: Mehta, A; Baker, T. A.; Shoup, M.; Brownson, K.; Amde, S.; Doren, E.; Shah, S; Kuo, P; Angelats, J.
Article Title: Biplanar flap reconstruction for pressure ulcers: experience in patients with immobility from chronic spinal cord injuries
Abstract: BACKGROUND: Surgical therapy for advanced-stage pressure ulcers recalcitrant to healing is a widely accepted practice. The present study examined the incidence of wound recurrence after reconstruction with fasciocutaneous versus combined (biplanar) muscle and fasciocutaneous flaps. METHODS: A retrospective review identified 90 nonambulatory patients with spinal cord injury who underwent reconstruction for persistent decubitus ulcers from 2002 to 2008. Electronic medical records were surveyed for patient comorbidities and postoperative complications. Statistical methods included the Fisher exact test and the Mann-Whitney U test with a 2-sided P value of less than .05. RESULTS: Among 90 patients reviewed, 33% (n = 30) received fasciocutaneous flaps and 66% (n = 60) underwent biplanar reconstruction. Comorbidities were the same between cohorts with the exception of a greater prevalence of diabetes in the biplanar group (27% vs 50%; P .05). The incidence of recurrence for biplanar flaps (25%) was significantly lower than for fasciocutaneous reconstruction (53%; P .01). CONCLUSIONS: Biplanar flap reconstruction should be considered for chronically immobilized patients at high risk for recurrent decubitus ulceration.
Keywords: Adult; Aged; Aged, 80 and over; Female; Humans; Middle Aged; Male; Treatment Outcome; Retrospective Studies; Recurrence; Buttocks; Chronic Disease; Surgical Flaps; Postoperative Complications/epidemiology; Reconstructive Surgical Procedures/methods; Paralysis/complications; Pressure Ulcer/etiology/surgery; Spinal Cord Injuries/complications
Journal Title: American Journal of Surgery
Volume: 203
Issue: 3
ISSN: 1879-1883; 0002-9610
Publisher: Unknown  
Journal Place: United States
Date Published: 2012
Start Page: 303
End Page: 6; discussion 306-7
Language: eng
DOI/URL:
Notes: CI: Published by Elsevier Inc.; JID: 0370473; 2011/08/07 [received]; 2011/10/27 [revised]; 2011/10/27 [accepted]; ppublish
LUC Authors
  1. Paul C. Kuo
    89 Kuo
  2. Shivani Shah
    4 Shah
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