PRESSURE SORES (DECUBITUS ULCERS) IN THE SPINAL PATIENT. THE PROBLEM OF TREATMENT CHOICE

Successful outcomes achieved in the treatment of severe pressure sores (III and IV stages) in spinal cord patients by means of conservative methods induced the Authors to critically review their previous approach in the management of this condition. Current guidelines refer just to the most suitable surgical techniques to be adopted in relation to the depth and to the site of the lesion. The Authors elaborated their own management guidelines that take into consideration several parameters, both local and general, i.e. the site, the aspect, the date of the lesion, age, cause and level of spinal injury, rehabilitation program, nutritional state, psychicological condition and ASA class. The multidisciplinary approach is the key to the success for the ulcer healing in order to reduce life-threatening complications and side effects. The Authors present the results of their 20 month clinical experience with this multidisciplinary approach in 39 patients suffering of 78 pressure sores in the Spinal Unit of “Centro Medico di Montescano (Fondazione S. Maugeri)” (Pavia-Italy