A Retrospective Study: Multivariate Logistic Regression Analysis of the Outcomes after Pressure Sores Reconstruction With Fasciocutaneous, Myocutaneous and Perforator Flaps

Publication date: Available online 23 April 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Yu-Jen Chiu, Wen-Chieh Liao, Tien-Hsiang Wang, Yu-Chung Shih, Hsu Ma, Chih-Hsun Lin, Szu-Hsien Wu, Cherng-Kang Perng
BackgroundDespite significant advances in medical care and surgical techniques, pressure sore reconstruction is still prone to elevated rates of complication and recurrence. We conducted a retrospective study to investigate not only complication and recurrence rates following pressure sore reconstruction, but also preoperative risk stratification as well.MethodsIn total, 181 pressure ulcers underwent flap operations between January 2002 and December 2013 were included in the study. We performed a multivariable logistic regression model, which offers a regression-based method accounting for the within-patient correlation of the success or failure of each flap.ResultsThe overall complication rate and recurrence rate for all flaps were 46.4% and 16.0%, respectively, with a mean follow-up period of 55.4±38.0 months. There were no statistically significant differences of complication and recurrence rates between three different reconstruction methods. In subsequent analysis, albumin≤3.0g/dl and paraplegia were significantly associated with higher post-operative complication. The anatomic factor, ischial wound location, significantly trended towards the development of ulcer recurrence. In the fasciocutaneous group, paraplegia had significant correlation to higher complication and recurrence rates. In musculocutaneous flap group, variables had no significant correlation to complication and recurrence rates. In the free-style perforator group, ischial wound location and malnourished status correlated with significantly higher complication rates; ischial wound location correlated with significantly higher recurrence rate.ConclusionsUltimately, our review of a noteworthy cohort with lengthy follow-up helped to identify and confirm certain risk factors that can facilitate a more informed and thoughtful pre and post-operative decision-making process for patients with pressure ulcers.



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