A Nation Under Pressure
Canadian experts discussed the pressure injury predicament across Canada from multiple perspectives.
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Additional Questions and Answers
Not all questions that were submitted through the Q&A box live during the education day were able to be answered. Please see below for additional answers to questions we couldn't get to live.
Surgical Closure of Pressure Injuries in Persons with Spinal Cord Injury
Aside from St Michael’s hospital, are there other Facilities (Plastic Surgeons) who have engaged in the surgical management of recalcitrant pressure injuries in toronto that can be consulted?
Currently there is a lack of reconstructive surgeons willing to do this surgery in Ontario. Dr Mahoney retired, and the program has slowed right down. It takes a village to get these patients through their surgical experience successfully. It may take some rebuilding and finding surgeons that are willing to operate on these patients.
- Laura Teague
Also wondering, did you capture data around re-injury and associated cost with this?
It was difficult to capture re-injury, as the DAD coding is really tricky. There were a few patients that developed PI after surgery, but the data on location, severity etc. could not be extracted from admin data. If the patient did not return to SMH, then we could not have determined re-ulceration. This is a limitation of this study.
Do you have a standard care pathway for these patients? Post-op seating protocols, admission to rehab hospital etc.
Thanks for this question. Dr McGillivray and I will be presenting on this very subject at the spinal cord meeting in November of this year. Please email me and I will share the PPT when we are done. Laura.email@example.com
Wondering is the cost per injury treated or total cost of all injuries treated per year?
We could only capture the cost in the one year prior to surgery. However, we all know that patients have ulcers for much longer than “one year prior”. This study had limits to timeframe ( as all do).
There was a lot of data missing – including age of the ulcer, and number of ulcerations over the same site, reulceration over the same site post- surgery. The data collected was from one hospital, and so it would not have been possible to find all of this data.
Finally, there were a few patients that had flap closure for 2 ulcers in the same encounter, but this was very low. I hope that this helps to clarify.
- Laura Teague