Abstract
Patients with pressure ulcers are generally older, have a long hospital stay and often have a variety of comorbidities. The decision to perform surgery for pressure ulcer management can be difficult because of concerns about the risk of postoperative complications. The aim of this study was to analyse the relationship between comorbid conditions and surgical outcomes in order to guide patient selection for pressure ulcer surgery. In 57 patients, data on age, defect size, operating time, hospital stay, body mass index, surgical site, mobility state, cardiac ischaemic history, diabetes, renal failure, ventilator dependency, tracheostomy state, use of haemodilution therapy and cancer were evaluated using stepwise multiple logistic regression analysis to determine the relationships between variables. There were no postoperative cardiac ischaemic events. Wound complications occurred in 8 patients (14%), pneumonia in 12 patients (21·1%) and mortality in 1 patient (1·7%). The risk of postoperative pneumonia increased 1·069-fold in elderly patients (odds ratio = 1·069, P < 0·05) and increased 44·17-fold in preoperative ventilator users (odds ratio = 44·17, P < 0·05). The risk of wound complication increased 1·012-fold with the presence of a larger defect site (odds ratio = 1·012, P < 0·05) and increased 7·474-fold in patients who received haemodilution therapy (odds ratio = 7·474, P < 0·05). Our results indicate that most comorbid conditions did not significantly affect postoperative cardiopulmonary or wound complications. However, the risk of postoperative pneumonia increased in patients with ventilator use or old age, and the risk of wound complication increased in patients with a large defect size and in those who used haemodilution therapy.