The following is a summary of “Surgical Reconstruction of Stage 3 and 4 Pressure Injuries: A Literature Review and Proposed Algorithm from an Interprofessional Working Group,” published in the May 2023 issue of Critical Care by Awad, et al.
For a study, researchers sought to assess the current limitations in surgical intervention for stage 3 and 4 pressure injuries (PIs) and propose an algorithm for surgical reconstruction based on a literature review and evaluation of clinical practice experience.
An interprofessional working group was formed to review the scientific literature and develop an algorithm for clinical practice. Data from the literature and institutional management comparisons were used to inform the algorithm, incorporating negative-pressure wound therapy and bioscaffolds in the surgical reconstruction of stage 3 and 4 PIs.
Surgical reconstruction of PIs was associated with relatively high complication rates. The adjunctive use of negative-pressure wound therapy has shown benefits, including reduced dressing change frequency.
However, the evidence for using bioscaffolds in standard wound care and as an adjunct to surgical reconstruction is limited. The proposed algorithm aims to minimize complications and improve patient outcomes in surgical interventions for stage 3 and 4 PIs.
The working group developed a surgical algorithm to reconstruct stage 3 and 4 PIs. Further validation and refinement of the algorithm would be conducted through additional clinical research.