ArticleBMC infectious diseases2018
Pressure ulcer-related pelvic osteomyelitis: evaluation of a two-stage surgical strategy (debridement, negative pressure therapy and flap coverage) with prolonged antimicrobial therapy.
Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Predictors of Complications and Recurrence After Pressure Injury Reconstruction in Spinal Cord Injury: A Systematic Review and Meta-Analysis.International wound journal · 2026Pooled it
- The association between pressure injury microbiome and wound healing: a systematic review.Frontiers in cellular and infection microbiology · 2025Pooled it
- Prehabilitation for Pressure Ulcer Surgery: A Practical and Evidence-based Guide.Plastic and reconstructive surgery. Global open · 2026Article
- Staged Flap Reconstruction of Massive Abdominal Loss of Domain and Sacral Pressure Injury to Restore Quality of Life: A Case Report.Microsurgery · 2026Article
- Review
- Influence of severity of illnesses on risk of death in intensive care unit patients with severity of pressure injuries as mediating variable.International wound journal · 2024Article
- [Clinical repair strategy for ischial tuberosity pressure ulcers based on the sinus tract condition and range of skin and soft tissue defects].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2024Observational
- A Review of Phage Therapy for Bone and Joint Infections.Methods in molecular biology (Clifton, N.J.) · 2024Review
- Negative pressure wound therapy for treating pressure ulcers.The Cochrane database of systematic reviews · 2023Review
- Short Antibiotic Treatment Duration for Osteomyelitis Complicating Pressure Ulcers: A Quasi-experimental Study.Open forum infectious diseases · 2023Article
- [Clinical effects of island posterior femoral composite tissue flaps in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2023Observational
- Hip Joint Infections Caused by Multidrug-Resistant Enterobacterales Among Patients With Spinal Cord Injury: Experience of a Reference Center in the Greater Paris Area.Open forum infectious diseases · 2022Article
- [Clinical effects of en bloc resection and debridement combined with gluteus maximus muscle flap in the treatment of ischial tubercle pressure ulcer complicated with chronic osteomyelitis].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2022Observational
- Simple and Efficient Pressure Ulcer Reconstruction via Primary Closure Combined with Closed-Incision Negative Pressure Wound Therapy (CiNPWT)-Experience of a Single Surgeon.Journal of personalized medicine · 2022Article
- Therapeutic strategies for chronic wound infection.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2022Review
- The modified bilobed flap for reconstructing sacral decubitus ulcers.Burns & trauma · 2020Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitis but has not been widely evaluated.
methodsAdult patients with pressure ulcer-related pelvic osteomyelitis treated by a two-stage surgical strategy were included in a retrospective cohort study. Determinants of superinfection (i.e., additional microbiological findings at reconstruction) and treatment failure were assessed using binary logistic regression and Kaplan-Meier curve analysis.
resultsSixty-four pressure ulcer-related pelvic osteomyelitis in 61 patients (age, 47 (IQR, 36-63)) were included. Osteomyelitis was mostly polymicrobial (73%), with a predominance of S. aureus (47%), Enterobacteriaceae spp. (44%) and anaerobes (44%). Flap coverage was performed after 7 (IQR, 5-10) weeks of NPT, with 43 (68%) positive bone samples among which 39 (91%) were superinfections, associated with a high ASA score (OR, 5.8; p = 0.022). An increased prevalence of coagulase negative staphylococci (p = 0.017) and Candida spp. (p = 0.003) was observed at time of flap coverage. An ESBL Enterobacteriaceae spp. was found in 5 (12%) patients, associated with fluoroquinolone consumption (OR, 32.4; p = 0.005). Treatment duration was as 20 (IQR, 14-27) weeks, including 11 (IQR, 8-15) after reconstruction. After a follow-up of 54 (IQR, 27-102) weeks, 15 (23%) failures were observed, associated with previous pressure ulcer (OR, 5.7; p = 0.025) and Actinomyces spp. infection (OR, 9.5; p = 0.027).
conclusionsPressure ulcer-related pelvic osteomyelitis is a difficult-to-treat clinical condition, generating an important consumption of broad-spectrum antibiotics. The lack of correlation between outcome and the debridement-to-reconstruction interval argue for a short sequence to limit the total duration of treatment.
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