Volume 38 Issue 12
Dec.  2022
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Pan NF,Liang ZH,Lin P,et al.Influence factors of poor efficacy after flap repair operation in patients with pressure ulcers[J].Chin J Burns Wounds,2022,38(12):1156-1161.DOI: 10.3760/cma.j.cn501225-20220228-00041.
Citation: Pan NF,Liang ZH,Lin P,et al.Influence factors of poor efficacy after flap repair operation in patients with pressure ulcers[J].Chin J Burns Wounds,2022,38(12):1156-1161.DOI: 10.3760/cma.j.cn501225-20220228-00041.

Influence factors of poor efficacy after flap repair operation in patients with pressure ulcers

doi: 10.3760/cma.j.cn501225-20220228-00041
Funds:

The Specific Research Fund of the Innovation Platform for Academicians of Hainan Province of China ysptzx202028

Hainan Health and Family Planning Industry Scientific Research Program 19A200080

More Information
  • Corresponding author: Pan Yunchuan, Email: pychuan@qq.com
  • Received Date: 2022-02-28
  •   Objective  To investigate the influence factors of poor efficacy after flap repair operation in patients with pressure ulcers.  Methods  The retrospective case series study was conducted. From January 2011 to June 2021, 125 patients with stage Ⅲ and Ⅳ pressure ulcers treated in Hainan General Hospital met the inclusion criteria. There were 82 males and 43 females, aged 15-90 (57±20) years. According to the postoperative effects, the patients were divided into poor efficacy group (47 cases) and good efficacy group (78 cases). The clinical data of patients in the two groups were collected, including the age, gender, location, stage, size, and bone exposure of pressure ulcers, preoperative microorganism culture results of wound exudate sample, whether combined with osteomyelitis, diabetes, lower limb paroxysmal myospasm, and gatism or not, the number of surgical debridement combined with negative-pressure wound therapy, type of surgical flap, postoperative position, and preoperative albumin, leukocyte, C-reactive protein (CRP), and hemoglobin. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chi-square test. The binary multivariate logistic regression analysis was conducted to screen the independent risk factors influencing the poor efficacy after flap repair operation in 125 patients with stage Ⅲ and Ⅳ pressure ulcers.  Results  The ratio of patients with lower limb paroxysmal myospasm in poor efficacy group was 22/47, which was significantly higher than 3/78 in good efficacy group (χ2=33.83, P<0.01). The preoperative hemoglobin level of patients in poor efficacy group was (102±17) g/L, which was significantly lower than (113±20) g/L in good efficacy group (t=-3.24, P<0.01). The preoperative CRP level of patients was 39.1 (14.1, 91.6) mg/L in poor efficacy group, which was significantly higher than 15.3 (6.6, 42.0) mg/L in good efficacy group (Z=-3.04, P<0.01). There were no statistically significant differences in other indexes between patients in the two groups (P>0.05). Multivariate logistic regression analysis showed that age, lower limb paroxysmal myospasm, and preoperative hemoglobin level were the independent risk factors for poor efficacy after flap repair operation in patients with pressure ulcers (with odds ratios of 1.03, 40.69, and 0.97, 95% confidence intervals of 1.00-1.06, 9.18-180.39, and 0.95-1.00, respectively, P<0.05 or P<0.01).  Conclusions  Poor efficacy after flap repair operation in patients with pressure ulcers is affected by many factors, among which the age, lower limb paroxysmal myospasm, and preoperative hemoglobin level are the independent risk factors.

     

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