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Treatment of ischial pressure sores. Our experience of 99 patients with 108 sores

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Abstract

Background

Ischial pressure sores concern patients in the sitting position and particularly the rehabilitated patients. Spontaneous healing may be very difficult without surgery, and ischial pressure sores have the highest recurrence rate among other decubitus. Furthermore, there is no consensus concerning the ideal surgical technique in order to definitely treat the patients. This is a retrospective analysis of the surgical treatment of ischial pressure sores aiming to identify the ulcer recurrence rate per surgical technique and describe the early complications.

Methods

This was a retrospective study that was conducted in Marseille, France, between 1988 and 2007. The medical records concerning patients with ischial pressure sores were collected and analyzed. The main objective was to identify the ulcer recurrence rate after ischial pressure sore surgical treatment. The secondary objective was the identification and description of early complications.

Results

Ninety-nine patients were finally selected and analyzed for 108 ischial pressure sore treatments. Primary endpoint analysis identified 25 recurrences for 108 sores (23.14 %). Hamstring V-Y advancement flap had 71 % recurrence rate. Wound dehiscence was the primary complication. Six out of seven hamstring V-Y advancement flaps had early complications.

Conclusions

Pressure sore treatment can be difficult and challenging. In this retrospective study, we have found that the hamstring V-Y advancement flaps have a much higher recurrence rate and a higher rate of complications. Our results may be limited by the retrospective nature of this study but they imply that the V-Y advancement flaps should not be used as a first choice for ischial pressure sore treatment.

Level of Evidence: Level IV, therapeutic study.

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Conflict of interest

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Ethical standards

This study has been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards set forth in the 1964 Declaration of Helsinki and its later amendments.

All persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study were omitted.

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Authors and Affiliations

  1. Plastic, Reconstructive and Aesthetic Surgery Department, La Conception University Hospital, 147 Boulevard Baille, 13005, Marseille, France

    Charalambos A. Georgiou, Pierre S. Nguyen, Zdravska Batchvarova, Jacques Bardot & Dominique Casanova

  2. Plastic Reconstructive and Aesthetic Surgery Department, St Roch University Hospital of Nice, 5 Pierre Devoluy, 0600, Nice, France

    Charalambos A. Georgiou

  3. Plastic, Reconstructive and Aesthetic Surgery Department, Hôpital Nord, University Hospital, Chemin des Bourrely, 13915, Marseille, France

    Cécile Philandrianos

Authors
  1. Charalambos A. Georgiou
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  2. Pierre S. Nguyen
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  3. Zdravska Batchvarova
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  4. Cécile Philandrianos
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  5. Jacques Bardot
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  6. Dominique Casanova
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Corresponding author

Correspondence to Charalambos A. Georgiou.

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Georgiou, C.A., Nguyen, P.S., Batchvarova, Z. et al. Treatment of ischial pressure sores. Our experience of 99 patients with 108 sores. Eur J Plast Surg 37, 667–672 (2014). https://doi.org/10.1007/s00238-014-1014-9

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  • DOI: https://doi.org/10.1007/s00238-014-1014-9

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