15. What is the cure rate for pressure sore patients? (PRS 1992; 89:272)
Answer:
While the short-term success of operative closure of pressure sores has been greatly enhanced with the advent of muscle flaps and air flotation beds, the long-term results have shown great variability. While short-term success rates of 80% are often reported, long-term recurrence rates have ranged from as low as 2 to 6% to as high as 33 to 100% depending on the paper cited. In the referenced paper, 40 patients were divided into 3 diagnostic categories (traumatic paraplegics - e.g. gunshot wound victims, nontraumatic paraplegics – e.g. meningomyelocele or benign spinal tumor, and nontraumatic nonparaplegics – elderly & debilitated). Although about 80% of patients were completely healed at time of discharge, within an average of 9 months, almost 70% of them developed recurrence. Traumatic paraplegics had the highest recurrence rate (79%). While nontraumatic nonparaplegics had 40% recurrence at the old site, an additional 29% of these patients developed a sore at a new site. No recurrences were seen in the nontraumatic paraplegics, but only 3 patients fell into this category. Nonetheless the authors felt that since younger age, greater motivation, and more stable social situations characterized all three patients these are possible factors in avoiding recurrence, and that operative therapy may not always be indicated for traumatic paraplegics and elderly debilitated patients.