Introduction:
Pressure ulcers, bedsores, or decubitus ulcers are serious medical conditions that are commonly seen in people who have limited mobility or are bedridden. These occur on the areas and skin which are in contact with a wheelchair or bed for a longer duration of time which causes damage to the skin and underlying tissue layers. Pressure ulcers or bed sores can be seen in various forms depending on the severity. It can be mild irritation and redness or deeper wounds that can expose bones and muscles. If left untreated, they can result in many serious complications like sepsis and infections. Advanced or chronic bedsores are usually treated using reconstructive surgery to repair the damaged tissues. This can include various techniques like flap surgery or skin grafting, which help in replacing the dead or damaged tissue with new or healthy tissue from another site. However, preventing bed sore is better than treating it with reconstructive surgery. Proper skin care, regular repositioning of the body, and use of support surfaces and cushions can help in reducing the development of bedsores.
What Is Bedsore Reconstruction?
A surgical procedure that helps in the repair and reconstruction of the damaged skin and underlying tissues, which are caused by pressure ulcers or bed sores, is called bed sore reconstruction. The bed sore reconstruction procedure is usually indicated in people with chronic or severe bed sores that do not respond to other types of treatment. Bedsore reconstructive surgery includes flap surgery and skin grafting, in which healthy tissue is taken from another part of the body and transplanted to the damaged area. It can sometimes include using artificial skin, which helps improve healing. The reconstructive surgical procedure is usually done in combination with other treatment forms like physical therapy, wound dressing, and antibiotics.
Which Are the Types of Bed Sore Reconstruction Techniques?
The procedure for bed sore reconstruction is selected depending on the severity and the position of the bed sore or the pressure ulcer. Different types of bed sore reconstruction procedures include the following:
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Skin Grafting - In this procedure, healthy skin is taken from another part of the body and is usually placed or grafted onto the affected or damaged area. The skin graft helps in replacing the dead or damaged tissue, and it also helps in improving healing.
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Flap Surgery - Flap surgery includes taking a section of a healthy tissue like muscle, skin, or fat from a closer area of the body and moving or replacing it to the affected or damaged site. This technique is used when there is involvement or damage of a larger area of tissue.
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VAC or Vacuum-Assisted Closure Therapy - It is done using a vacuum device which helps in wound healing. This vacuum-assisted closure therapy device will apply negative pressure to the wound site, which helps in the removal of excess fluid present in the damaged area and will promote healing.
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Debridement - The damaged or dead tissue is removed from the wound. The debridement is done using laser, scalpel, or any other specialized tool.
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Skin Substitutes - This includes artificial skin substitutes which will help in improving the healing in the damaged or affected region. Skin substitutes include synthetic and biological materials, which can help in replacing the damaged tissue.
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Muscle Flap Surgery - A section or part of the muscle is taken from another part of the body and is used to replace the area of the damaged tissue. This muscle flap surgery is usually done in cases where the bed sore or the pressure ulcer has invaded the underlying joint.
What Are the Indications of Bed Sore Reconstruction Procedure?
The indications of the bedsore reconstruction procedure include the following:
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Chronic and non-healing bed sore that does not respond to normal or conservative treatment like medication or wound dressing.
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Deep and large bed sore need reconstruction procedure to replace the infected and damaged tissue which help in preventing further infection and injury.
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When the bone or joint is exposed due to the damage caused by the pressure ulcer or bedsore.
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If there is necrotic tissue or dead tissue.
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If there is a recurrence of bed sore or pressure ulcers, then reconstructive procedures are indicated.
What Are the Contraindications of Bed Sore Reconstruction Procedure?
The contraindications of the bedsore reconstruction procedure include the following:
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In cases of active infection.
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When there is poor overall health.
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Reduced blood flow.
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Elderly patients.
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People with unrealistic expectations.
How Is the Bed Sore Reconstruction Procedure Done?
This procedure includes repairing and reconstructing the tissues which are damaged due to bedsore or pressure ulcers. The following steps are included in the bedsore reconstruction procedure:
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Anesthesia - The patient is administered anesthesia to numb the damaged or affected area which will help in preventing pain during the reconstructive procedure.
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Preparing the Wound - Any dead tissue or debris present in the wound is cleaned and removed. This is done using laser or ultrasound which helps in improving the healing.
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Removing Tissue - In severe cases of bed sore, the dead or damaged tissue is removed which will help in preventing further infection and will promote healing.
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Wound Closure - After the completion of the reconstruction procedure, the wound is closed using staples, adhesive strips, or stitches. The dressing is used to promote healing and protect the wound.
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Post-operative Care - After the reconstructive surgical procedure, the patient is closely monitored for any change in the signs of infection, or in case any complication occurs. They prescribe medications that will help in promoting wound healing and prevent further injury.
Conclusion:
In conclusion, bedsores or pressure ulcers are a type of serious medical condition that can cause severe complications if left untreated, like the exposure of bone and muscles, which causes infection. Reconstructive surgery helps in the treatment of advanced or chronic bed sore, which helps in the repair of the damaged skin and underlying tissues. However, regular repositioning and proper skin care can help in preventing bed sores which helps in reducing the risk.
