2024 Volume 44 Issue 4 Pages 149-157
Introduction: Reconstructive surgery for sacral and ischial pressure ulcers carries a high risk of surgical site infection (SSI) owing to contamination from the perineum. In this study, patients underwent a staged reconstruction, which involved flap reconstruction after debridement and wound bed preparation. The aim of this study was to identify risk factors for SSI in patients who underwent perforator-based transposition flap reconstruction for sacral and ischial pressure ulcers.
Method: Eighty-three flaps in the study cohort were assessed for patient age and sex, flap size, operative time, bacterial species in the wound, and other potential SSI risk factors.
Result: In the group affected by SSI, larger flap size (p = 0.04; odds ratio [OR]: 1.03; 95% confidence interval [CI]: 1.00-1.06) and longer operative time (p = 0.04; OR: 1.02; 95% CI: 1.00-1.03) were significant risk factors. Methicillin-resistant staphylococci (Staphylococcus aureus or coagulase negative staphylococci, p = 0.03) and Bacteroides fragilis group (p = 0.03) detected in the wound were also risk factors.
Discussion and Conclusion: Flap size should be considered. The risk of bacterial contamination increases with long surgery time. Thorough debridement and appropriate antibiotic selection are necessary.
