Complications after pressure ulcer surgery – a study of 118 operations in spinal cord injured patients

Figures & data

Figure 1. Flow chart. Cases identified through records search (138), exclusion criteria, and included patients (118).

Table 1. Characteristics of the study population.

All cases	118
Sex
Male	82 (69.5 %)
Female	36 (30.5 %)
Age in years, mean (range)	49.7 (17-82)
0–18	1 (0.8 %)
19–39	37 (31.4 %)
40–59	41 (34.7 %)
60–79	36 (30.5 %)
80+	1 (0.8 %)
Missing	2 (1.7 %)
Spinal cord injury
Paraplegic	87 (73.7 %)
Tetraplegic	31 (26.3 %)
Complete	95 (80.5 %)
Incomplete	23 (19.5 %)
Cause of spinal cord injury
Trauma	79 (67.0 %)
Meningomyelocele	20 (17.0 %)
Myelitis / other spinal infection	12 (10.2 %)
Aortic aneurysm	3 (2.5 %)
Spinal cord malignancy	3 (2.5 %)
Multiple sclerosis	1 (0.8 %)
Smoking
Never known smoker	72 (62.6 %)
Current smoker	15 (13.0 %)
Quit smoking 1–3 months before surgery	14 (12.2 %)
Previous smoker (>3 months ago)	14 (12.2 %)
Missing	3 (2.5 %)
Diabetes mellitus
No known diabetes	102 (86.5 %)
Diabetes mellitus, per oral medication	9 (7.6 %)
Diabetes mellitus, insulin dependent	7 (5.9 %)
BMI, mean (range)	22.8 (14.9-46.0)
≤18.99	15 (12.7 %)
19–24.99	35 (29.7 %)
≥25.0	18 (15.3 %)
Missing	50 (42.4 %)

Cases of individuals completing the treatment programme for pressure ulcers in Stockholm January 2002 to January 2019.

Table 2. Post-operative complications by Clavien–Dindo, with examples.

Grades	Cases, n (%)
No complication	67 (56.8 %)
Grade I	12 (10.2 %)
E.g. Post-operative need of antiemetics, analgetics, diuretics, electrolytes
Grade II	32 (27.1 %)
Per- or post-operative need of drugs other than above, e.g. blood transfusion, antibiotics
Grade III	5 (4.2 %)
Need of surgical intervention
IIIa intervention not under general anesthesia	1 (0.8 %)
IIIb intervention under general anesthesia	4 (3.4 %)
Grade IV	2 (1.7 %)
Life-threatening complication requiring intensive care unit management
IVa single organ dysfunction	2 (1.7 %)
IVb multi organ dysfunction	0
Grade V	0
Death of patient

Table 3. Flap-related complications.

Complication	Number of cases (%)
Wound dehiscence	28 (23.7 %)
Local infection	9 (7.6 %)
Bleeding or hematoma	8 (6.8 %)
Flap necrosis	5 (4.2 %)
Total	50*

*Total number of flap-related complications, corresponding to a total of 30 cases (several complications could occur in the same patient).