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  4. The coccygeal pressure ulcer—does coccygectomy prevent recurrence?

The coccygeal pressure ulcer—does coccygectomy prevent recurrence?

Spinal Cord Series and Cases, 2020 · DOI: https://doi.org/10.1038/s41394-020-0299-0 · Published: May 25, 2020

Spinal Cord InjurySurgeryDermatology

Simple Explanation

This study investigates whether removing the coccyx (coccygectomy) helps prevent pressure ulcers from returning in people with paraplegia. The study found that coccygectomy, along with flap surgery, is a suitable method for preventing the return of pressure ulcers in the coccygeal area. The study highlights the importance of preventing pressure ulcers in the first place through education and regular check-ups.

Study Duration
2001 to 2019
Participants
49 individuals with coccygeal pressure ulcers
Evidence Level
Retrospective, non-randomized cohort study

Key Findings

  • 1
    Coccygectomy, in addition to rotation flap surgery, is a suitable method for recurrence prevention of pressure ulcer in the coccygeal area.
  • 2
    86% of individuals who underwent coccygectomy experienced no relapse in the first year.
  • 3
    Five years after coccygectomy, 78% of individuals remained relapse-free.

Research Summary

This retrospective study evaluated the efficacy of coccygectomy for preventing the recurrence of coccygeal pressure ulcers in individuals with paraplegia. The study found that coccygectomy, combined with rotation flap surgery, is a suitable method for preventing pressure ulcer recurrence in the coccygeal area. The authors conclude that prevention is key, emphasizing structured education, skin checks, and proper positioning to avoid pressure ulcers initially.

Practical Implications

Surgical Intervention

Coccygectomy with flap surgery is a viable option for preventing recurrent coccygeal pressure ulcers.

Preventative Measures

Structured education and regular check-ups are crucial for preventing initial pressure ulcers.

Post-operative Care

Adherence to the 'Basel Decubitus Concept' is important for post-coccygectomy care.

Study Limitations

  • 1
    Lack of a control group
  • 2
    Inclusion of geriatric individuals with multiple co-morbidities
  • 3
    High mortality rate of individuals within 5 years after coccygectomy

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