TY - JOUR
T1 - Characteristics of recurrent pressure ulcers in veterans with spinal cord injury
AU - Bates-Jensen, Barbara M.
AU - Guihan, Marylou
AU - Garber, Susan L.
AU - Chin, Amy S.
AU - Burns, Stephen P.
PY - 2009
Y1 - 2009
N2 - Background/Objective: To describe characteristics of recurrent pressure ulcers (PrUs) in veterans with spinal cord injury (SCI). Design: Descriptive, cohort study. Settings and Participants: Twenty-four veterans with SCI from 6 SCI centers in the Department of Veterans Affairs. Methods: Data from a prospective study evaluating PrUs were analyzed for 24 veterans with 29 recurrent PrUs during 9 months. Additional retrospective medical record data were analyzed for 15 veterans who received inpatient treatment. Results: Participants were male, 50% non-Hispanic white, with paraplegia (63%), complete SCI (83%), a mean age of 56 years, and mean time since SCI of 21 years. Most PrUs recurred (63%, n = 15 patients) in the same location as the most recent ulcer and at the ischial tuberosities (63%). Mean time to recurrence was 16.6 weeks. PrUs were stage III (28%, n = 8) or IV (45%, n = 13) with undermining (48% necrotic slough (50%), and minimal exudate. One third were (n = 9) larger than 16 cm2. Mean Bates-Jensen Wound Assessment Tool Score was 33.63. Inpatient medical record data (n = 15) showed 73% with documentation indicating infection treated with antibiotics (53%, n = 8 patients), osteomyelitis (47%, n = 7), and/or cellulitis (13%, n = 2) noted. Plastic surgery consultation was obtained for 67% with surgery as an option for 73% (1 without consultation). Scheduled repositioning was documented for 21%. Conclusions: Most PrUs were severe, located at the same anatomic site, and recurred within 4 months, suggesting that the recurrent ulcers were more likely incomplete healing of the initial PrUs. This sample of veterans with SCI provides early data on recurrent PrU characteristics.
AB - Background/Objective: To describe characteristics of recurrent pressure ulcers (PrUs) in veterans with spinal cord injury (SCI). Design: Descriptive, cohort study. Settings and Participants: Twenty-four veterans with SCI from 6 SCI centers in the Department of Veterans Affairs. Methods: Data from a prospective study evaluating PrUs were analyzed for 24 veterans with 29 recurrent PrUs during 9 months. Additional retrospective medical record data were analyzed for 15 veterans who received inpatient treatment. Results: Participants were male, 50% non-Hispanic white, with paraplegia (63%), complete SCI (83%), a mean age of 56 years, and mean time since SCI of 21 years. Most PrUs recurred (63%, n = 15 patients) in the same location as the most recent ulcer and at the ischial tuberosities (63%). Mean time to recurrence was 16.6 weeks. PrUs were stage III (28%, n = 8) or IV (45%, n = 13) with undermining (48% necrotic slough (50%), and minimal exudate. One third were (n = 9) larger than 16 cm2. Mean Bates-Jensen Wound Assessment Tool Score was 33.63. Inpatient medical record data (n = 15) showed 73% with documentation indicating infection treated with antibiotics (53%, n = 8 patients), osteomyelitis (47%, n = 7), and/or cellulitis (13%, n = 2) noted. Plastic surgery consultation was obtained for 67% with surgery as an option for 73% (1 without consultation). Scheduled repositioning was documented for 21%. Conclusions: Most PrUs were severe, located at the same anatomic site, and recurred within 4 months, suggesting that the recurrent ulcers were more likely incomplete healing of the initial PrUs. This sample of veterans with SCI provides early data on recurrent PrU characteristics.
KW - Bates-Jensen wound assessment tool
KW - Closure, mucocutaneous flap
KW - Paraplegia
KW - Pressure ulcers, recurrent
KW - Salzburg pressure ulcer risk score
KW - Spinal cord injuries
KW - Veterans
KW - Wound healing
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U2 - 10.1080/10790268.2009.11760750
DO - 10.1080/10790268.2009.11760750
M3 - Article
C2 - 19264047
AN - SCOPUS:63049134574
SN - 1079-0268
VL - 32
SP - 34
EP - 42
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
IS - 1
ER -