Closed-incision negative pressure wound therapy (NPWT) in elderly patients following sacral pressure sore reconstruction

• Published in: BMC geriatrics 2024-11, Vol.24 (1), p.906-9, Article 906
• Main Authors: Jeong, Ji Won, Lee, Seungkeun, Park, Jun Ho
• Format: Article
• Language: English
• Subjects: Aged; Aged patients; Aged, 80 and over; Anus; Bedsores; Care and treatment; Caregivers; Complications; Complications and side effects; Debridement - methods; Dehiscence; Fecal incontinence; Feces; Female; Humans; Hygiene; Infections; Male; Methods; Negative pressure wound therapy; Negative-Pressure Wound Therapy - methods; Older people; Patients; Plastic Surgery Procedures - methods; Postoperative; Pressure; Pressure sore; Pressure ulcer; Pressure Ulcer - etiology; Pressure Ulcer - therapy; Pressure ulcers; Prevention; Reconstructive surgery; Retrospective Studies; Risk factors; Sacral sore; Sacrum; Sacrum - surgery; Skin; Statistical analysis; Surgeons; Surgery, Plastic; Surgical drains; Surgical Flaps; Wound drainage; Wound healing; Wound infection; Wounds and injuries
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-024-05526-9

Pressure sores significantly affect elderly patients, with the sacrum being especially vulnerable, often due to its proximity to the anus and potential for fecal contamination. Despite preventive measures such as frequent repositioning and specialized cushions, some sores still necessitate surgical intervention. Postoperative care focuses on monitoring, hygiene, and pressure alleviation. This study assessed the efficacy of Closed-Incision Negative Pressure Wound Therapy (CI-NPWT) for postoperative wound management in patients with sacral pressure sores treated with local flaps. A retrospective analysis was performed on sacral sore patients who underwent reconstructive surgery from March 2019 through April 2023. Surgical procedures involved debridement and wound coverage using gluteal artery perforator-based fasciocutaneous flaps, followed by postoperative monitoring. Patients were grouped into conventional monitoring or NPWT management, with the latter utilizing the INFOV.A.C. The therapy unit was calibrated to 125 mmHg. Data on patient demographics, flap metrics, fluid drainage amounts, and six-month postoperative outcomes were collected, and then analyzed with SPSS Statistics. In this study of 52 patients with sacral pressure sores, the NPWT group (n = 25) showed significantly fewer flap complications and a lower drainage volume on the seventh postoperative day (mean 17.2 cc) compared to the conventional dressing group (mean 27.8 cc, P