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Title: Surgical treatment of sacral pressure wounds in patients with COVID-19: A case series
Authors: Ferreira, Joao
Nicolas, Gregory
Valente, Daniel
Milcheski, Dimas
Saliba, Marita
Gemperli, Rolf
Affiliations: Faculty of Medicine 
Keywords: COVID-19
Negative-pressure wound therapy
Sacral pressure lesions
Issue Date: 2023
Part of: Journal of Plastic, Reconstructive and Aesthetic Surgery
The COVID 19 pandemic has resulted in an increased number of patients requiring intubation and intensive care. This has led to an increased incidence of sacral pressure ulcers requiring surgical management. We report our experience of COVID 19 related sacral pressure ulcers requiring surgical reconstruction.

A case series study was performed with 12 patients who presented grade IV sacral pressure ulcers after hospitalization for COVID-19 in a single institution. The mean age was 49.8 years and the most frequent comorbidities were arterial hypertension, diabetes and obesity, each present in 6 patients. All of them were submitted to surgical reconstruction with fasciocutaneous flaps after improvement of their clinical status. Follow up time was of at least 30 days after reconstruction. Preoperative laboratory tests and surgical outcomes were compared to data available in the literature.

No major dehiscence was observed and minor dehiscence happened in 2 cases (16.7%). Out of the 12 patients, 8 (66.7%) had hemoglobin levels less than 10.0 and 5 (41.7%) had albumin levels less than 3.0, though this did not lead to a higher rate of complications.

This study showed that ambulating patients with grade IV pressure ulcer after COVID- 19 infection may undergo debridement, negative-pressure wound therapy and closure with local flaps with adequate results and minimal complication rate.
ISSN: 17486815
DOI: 10.1016/j.bjps.2022.11.060
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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