Surgical therapy for complex pelvic pressure injuries: a review of outcomes for five consecutive years and a proposal for a navigator in the care pathway

Abstract

Introduction: An advanced pelvic PI is a challenging problem that requires care from multiple disciplines.

Objective: This study is a critical evaluation of wound recurrences after surgical repair, and an analysis of factors that may contribute to surgical failures. This study also provides a literature review of pelvic PIs and proposes how a navigator embedded in the wound care department could play a role in decreasing surgical failures.

Methods: A retrospective cohort study of 33 consecutive surgeries for closure of complex pelvic PIs in 22 patients was conducted.

Results: Recurrences developed in 17 of 33 surgeries (52%). Recurrences were seen most frequently in those undergoing simultaneous repair of 2 sites and those who had undergone prior surgeries.

Conclusions: Long-term healing after repair of complex pelvic PIs remains a challenge, especially in certain high-risk populations. A significant portion of recurrences develop after a period of healing, so identifying and addressing factors that lead to wound breakdown following hospital discharge is a critical area of care improvement. A navigator care coordinator within the wound care department may play an important role in preventing wound recurrences.