People with neuromotor disability (i.e. following an inborn or acquired spinal cord, cerebral or peripheral neurological lesion) are at high risk of osteomyelitis-associated pressure ulcers. The management of osteomyelitis-associated pressure ulcers is controversial. In our center, patients benefit from a one stage surgical management with bone shaving and flap covering osteitis of pressure ulcer to perform wound closing. Surgery is followed by an antibiotic treatment, secondarily adapted to intraoperative samples. The aim of this study is to describe the cohort and to identify factors associated with failure (or success) in this frail population.
This is a prospective, monocentric, cohort study of neurological disabled inpatients subjects treated in the perioperative disability unit (UPOH) of our university hospital for osteomyelitis-associated pressure ulcer by surgical flaps and anti bacterial agents. All eligible inpatient subjects with neuromotor disability and admitted for the treatment of osteomyelitis-associated pressure ulcers by surgical flaps will be consecutively included. Patients are followed up in consultation at 30 or 45 days after surgery, and in consultation or teleconsultation at 12 months after surgery. Data will be collected from the patients' medical records, in particular data related to their clinical, radiological, biological, and physiological examinations. Data related to sitting, nutrition, spasticity, bladder and bowel disorders, bacteriological sampling and antibiotic treatments will be collected. This is a routine care study; no procedures are added for research purposes. It is an ancillary study to the NO-AGING study.
Study Type
OBSERVATIONAL
Enrollment
400
Surgical flap and anti-bacterial agents
Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, AP-HP
Garches, France
RECRUITINGSuccess at 12 months after surgery
Success is defined as the absence of surgical revision, the absence of additional antibiotic therapy, and the absence of local care at the surgical site.
Time frame: 12 months after surgery
Success at 30-45 days after surgery
Success is defined as the absence of surgical revision, the absence of additional antibiotic therapy, and the absence of inflammatory signs or pus leakage or deep disunion of more than 2 cm.
Time frame: 30-45 days after surgery (depening on the surgical technique)
Description of the patients' bacteriological tests
Intraoperative samples and drain samples.
Time frame: Through hospital admission, up to 7 days after surgery
Death
Obtained from the INSEE database.
Time frame: 12 months after surgery
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