Opinion/Feedback

Surgical indication is recommended for specific locations (pelvic stage 3 and 4 pressure ulcers) and if medical treatment is impossible:

– global patient assessment is recommended before surgical indication with benefits and risks analysis;

– analysis is conducted on several stages;

– risk factors analysis and control level;

– efficiency analysis about medical and preventive coverage;

– pressure ulcer origin analysis;

– compliance patient assessment (care contract);

– systematic pre operative procedure is recommended:

– multi-disciplinary et pluriprofessionnal consultation;

– psychological assessment and follow up;

– radiological assessment (systematical, no systematical IRM except if osteitis, no TDM, no scintigraphy);

– biological assessment (inflammatory nutritional, micro biological);

– no pre-operative antibiotherapy;

– specify definition of surgical type

– realize pre-operative micro biological taking is recommended:(according to bone aspect):

– enforce systematic post operative procedures is recommended:

– plan patient installation: every patient must have a preventive mattress and book curative mattress for multiple scrap;

– plan total immediate post operative dumped according to patient compliance in PRM ward (during at least 3 weeks, often 4);

– organize seated station progressive recharging in PRM ward (during at least 3 weeks);

– extend patient supervision and allow seated station;

– plan further supervision.