Risk factors for recurrence of pressure ulcers after defect reconstruction

Publication from Coremed

Paul Wurzer, MD, MMS, Raimund Winter, MD, Sebastian O. Stemmer, MD, Josipa Ivancic, MD, Patricia B. Lebo, MD, Gabriel Hundeshagen, MD, MMS, Janos Cambiaso-Daniel, MD, Franz Quehenberger, PhD, Lars-Peter Kamolz, David B. Lumenta

Wound Repair and Regeneration , 1/2018


Patients suffering from pressure ulcers remain to be a challenging task for nursing
staff and doctors in the daily clinical management, putting—notably in the case of
recurrences—additional strain on the constantly reduced resources in public
healthcare. We aimed to assess the risk factors for the recurrence of pressure
ulcers at our institution, a tertiary referral center. In this retrospective analysis of
patients admitted to our division we identified risk factors for pressure ulcer
recurrence. The hospital patient database search included all patients with a
diagnosis of pressure ulcers of the torso and lower extremity. One hundred sixtythree
patients were diagnosed with pressure ulcers and 55 patients with 63
pressure ulcers met our inclusion criteria. The 17 recurrences (27%) had an
average follow-up of 728 days. Most presented with lesions of the ischial
tuberosity (n524). Recurrence was statistically associated with defect size
(p50.013, Cox regression analysis), and serum albumin levels (p50.045,
Spearman correlation), but no association was found for body mass index,
bacterial profile, comorbidities, localization, previous surgery, or time-to-admission
for reconstruction (all p>0.05). Supported by the recent literature we identified
factors like defect size to be associated with pressure ulcer recurrence, but not
with time-to admission for reconstruction or number of previous debridements.
Whether laboratory values like serum albumin levels were the cause, the result or
associated with pressure ulcer recurrence warrants further investigation.