Protocollo clinico-assistenziale nel trattamento delle ulcere da decubito

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COD: 119-124-1 Categorie: ,

Antonio Bocchi, Michele Maria Dominici, Maurizio Taglia, Edoardo Caleffi, Cristiano Dominici

Ann. Ital. Chir., 2007; 78: 119-124

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The decubital ulcers treatment needs a complex clinical approach. The ulcer healing and the absence of recurrences are
not only the result of a correct surgical operation. The purpose of this work is to identify all the clinical and nursing
parameters that can provide long lasting healing. We treated 105 decubital ulcers in various body areas (sacralis, ischiatic,
trochanteric and calcanear regions) and we defined a clinical protocol that starts from prevention, to the admission,
till the convalescence. We obtained satisfactory results with few post-operative complications and recurrences. Our protocol
is widely confirmed by various authors (the radical toilette, the use of fasciocutaneous and musculocutaneous flaps
and the importance of nutrition. In particular, the use of easier flaps (cutaneous, fasciocutaneous), is preferred in the
first surgical option to leave other more complex techniques (musculocutaneous flap) for the recurrences treatment. Our
protocol follows the patient from the first visit till several months after dismission during convalescence. The pre-operative
measures (nutritional state correction, infection care, detersion improvement) as well the post-operating ones (use of
circulating fluid beds, rest in bed for at least one month) result to be mandatory for a successful outcome.

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