Prevention and Management of Pressure Sores in Spinal Cord Injury Patients

Abstract

Introduction: Pressure sores are devastating complications of spinal cord injury, leading to sepsis, prolonged hospitalization, and death. This review evaluates surgical and preventive strategies.

Methods: A literature review focused on randomized trials and cohort studies of pressure sore prevention (support surfaces, repositioning) and surgical reconstruction (flap coverage). Outcomes: healing rate, recurrence, and complications.

Results: Thirty-five studies (n=2,204 patients) were analyzed. High-specification foam mattresses reduced pressure sore incidence by 60% compared to standard. Repositioning every two hours was effective but adherence was low. Surgical flap closure achieved primary healing in 85% of stage IV sores. Recurrence at one year was 20%, associated with patient non-adherence and spasticity. Post-operative complications included hematoma (10%) and dehiscence (8%).

Discussion: Prevention is paramount but often fails due to patient and caregiver factors. Surgical reconstruction is effective but recurrence is common without behavior modification. Flap selection (gluteal, fasciocutaneous) depends on sore location.

Conclusions: Multidisciplinary programs combining prevention and surgery are essential. Long-term patient education and follow-up reduce recurrence rates.