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The coccygeal pressure ulcer-does coccygectomy prevent recurrence?


Huber, Christian; de Roche, Roland; Rinaldo, Carmen; Hund-Georgiadis, Margret; Jukema, Gerrolt Nico (2020). The coccygeal pressure ulcer-does coccygectomy prevent recurrence? Spinal Cord Series and Cases, 6(1):50.

Abstract

STUDY DESIGN This is a retrospective, non-randomized cohort study, with data collected during the regular annual visits between 2001 and 2019.
OBJECTIVES The aim of this study was to evaluate the efficacy of coccygectomy for coccygeal pressure ulcers in individuals with paraplegia due to spinal cord injury or other neurological causes and to evaluate its role in the prophylaxis of ulcer recurrence.
SETTINGS This study included inpatients and outpatients with a coccygeal pressure ulcer who were treated surgically at our Institution REHAB Basel and were followed with regular annual check-ups.
METHODS Individuals with category 3 or 4 acute or chronic coccygeal pressure ulcer (classification according European Pressure Ulcer Advisory Panel (EPUAP)) received coccygectomy in addition to rotation flap surgery. The operative care was provided exclusively by the head of the plastic surgery department at REHAB Basel. Standardized follow-up treatment was carried out according to the "Basel Decubitus Concept" and thus allowed continuous and usually lifelong, regular follow-up care.
RESULTS Forty-nine individuals underwent coccygectomy from 2001 to 2019 due to coccygeal category 3 or 4 pressure ulcers. The observation period was between 1.5 and 18.3 years. In 86% of the individuals, no relapse occurred during the first year. Over the next 5 years 78% remained relapse free.
CONCLUSIONS In coccygeal pressure ulcer category 3 or 4, coccygectomy, in addition to sufficient rotation flap surgery, is a suitable method for recurrence prevention of pressure ulcer in this anatomic area.

Abstract

STUDY DESIGN This is a retrospective, non-randomized cohort study, with data collected during the regular annual visits between 2001 and 2019.
OBJECTIVES The aim of this study was to evaluate the efficacy of coccygectomy for coccygeal pressure ulcers in individuals with paraplegia due to spinal cord injury or other neurological causes and to evaluate its role in the prophylaxis of ulcer recurrence.
SETTINGS This study included inpatients and outpatients with a coccygeal pressure ulcer who were treated surgically at our Institution REHAB Basel and were followed with regular annual check-ups.
METHODS Individuals with category 3 or 4 acute or chronic coccygeal pressure ulcer (classification according European Pressure Ulcer Advisory Panel (EPUAP)) received coccygectomy in addition to rotation flap surgery. The operative care was provided exclusively by the head of the plastic surgery department at REHAB Basel. Standardized follow-up treatment was carried out according to the "Basel Decubitus Concept" and thus allowed continuous and usually lifelong, regular follow-up care.
RESULTS Forty-nine individuals underwent coccygectomy from 2001 to 2019 due to coccygeal category 3 or 4 pressure ulcers. The observation period was between 1.5 and 18.3 years. In 86% of the individuals, no relapse occurred during the first year. Over the next 5 years 78% remained relapse free.
CONCLUSIONS In coccygeal pressure ulcer category 3 or 4, coccygectomy, in addition to sufficient rotation flap surgery, is a suitable method for recurrence prevention of pressure ulcer in this anatomic area.

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Additional indexing

Item Type:Journal Article, not_refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Trauma Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:18 June 2020
Deposited On:22 Jun 2020 07:39
Last Modified:29 Jul 2020 15:19
Publisher:Nature Publishing Group
ISSN:2058-6124
OA Status:Closed
Publisher DOI:https://doi.org/10.1038/s41394-020-0299-0
PubMed ID:32555143

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