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. 2023 Jul 21;59(7):1342.
doi: 10.3390/medicina59071342.

Negative Pressure Wound Therapy (NPWT) after Hybrid Reconstruction of Occipital Pressure Sore Using Local Flap and Skin Graft

Seungchul Baek  1 , Jun Ho Park  1
Affiliations

Negative Pressure Wound Therapy (NPWT) after Hybrid Reconstruction of Occipital Pressure Sore Using Local Flap and Skin Graft

Seungchul Baek et al. Medicina (Kaunas). .

Abstract

Background and objectives: Pressure sores are a common medical burden among patients, particularly those who are bedridden or frail. Surgical management of occipital pressure sores poses unique challenges due to limited elasticity and the spherical shape of the scalp. This study aims to evaluate the efficacy and safety of a novel reconstruction method utilizing a local transpositional flap and split-thickness skin graft with negative pressure wound therapy (NPWT) for occipital pressure sore treatment. Material and methods: A retrospective analysis was performed on patients with occipital pressure sores who underwent hybrid reconstructions using a local flap and split-thickness skin graft in conjunction with NPWT. Surgical outcomes, including flap survival rate, graft take percentage, and complications, were assessed. A comparative analysis was performed between the NPWT group and the conventional dressing group. Results: The NPWT group (n = 24) demonstrated a significantly higher mean graft take percentage at postoperative day 14 compared with the conventional dressing group (n = 22) (98.2% vs. 81.2%, p < 0.05). No significant difference in flap survival rate was observed between the two groups. Conclusions: As the aging population continues to grow, occipital pressure sores have gained significant attention as a crucial medical condition. The innovative surgical method incorporating NPWT offers an efficient and safe treatment option for patients with occipital pressure sores, potentially establishing itself as the future gold standard for managing this condition.

Keywords: local flap; negative pressure wound therapy; occipital scalp; pressure sores; split-thickness skin graft.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) A 52-year-old female presented with two separate occipital scalp pressure sores. (B) Local flap elevation, leaving deep tissue containing periosteum. (C) Postoperative photographic finding immediate after operation. (D) Postoperative photographic findings in 3-month after operation.
Figure 2
Figure 2
(A) A 75-year-old female presented with an occipital scalp pressure sore. (B) Bone exposure after debridement. (C) Local flap elevation, through subgaleal dissection. (D) Postoperative photographic finding with NPWT dressing. (E) Postoperative photographic findings 3 months after operation.
See this image and copyright information in PMC

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