Pressure ulcer closure: Impact of demographics, spinal cord injury, and wound characteristics

Summary: Abstract Body: Introduction: Pressure ulcers (PUs) are a significant dermatological concern, particularly in patients with limited mobility. This study analyzed factors influencing PU closure outcomes, focusing on spinal cord injury (SCI) history, demographics, and pre-operative wound characteristics. Methods: In a prospective observational study at a single institution, 38 patients with stage III/IV PUs undergoing surgical debridement and closure were evaluated. Data on wound characteristics, complications, and healing outcomes were collected pre-operatively and at 14 days, 1 month, 6 months, and 1 year post-operatively. Results: Patients with SCI (36.8%) exhibited higher post-operative complications at post-operative day 14 (POD14) (mean 1 vs. 0.36, p < 0.05), with wound dehiscence being most common. They also had an increased risk of open wounds at POD14 (relative risk [RR] = 1.4, p < 0.05) and 1 month (RR = 2.18, p < 0.05), though this was not observed at 6 months or 1 year. Demographic analysis revealed that Black patients (23.6%) had longer initial wound lengths compared to others (7.65 cm vs. 5.12 cm, p < 0.05). Additionally, wound location significantly impacted outcomes; sacral wounds had higher complication rates (44% vs. 11% for ischial wounds, OR = 0.16, 95% CI 0.04-0.59) and longer hospital stays (mean increase of 1.7 days, p = 0.04). Larger wound volume was associated with lower closure rates at POD14 (p = 0.006). Conclusion: These findings underscore the need for personalized dermatological care strategies, particularly for patients with SCI, larger wound volumes, and sacral wound locations. Addressing demographic disparities is crucial to improving PU management and patient outcomes. Namrata Chintalapati¹, Kirtana Sandepudi¹, Robert D. Galiano² 1. Northwestern University Feinberg School of Medicine, Chicago, IL, United States. 2. Northwestern Memorial HealthCare, Chicago, IL, United States. Clinical Research: Epidemiology and Observational Research