A Holistic Approach to Manage Pressure Ulcers

Background: A pressure ulcer is a difficult problem for reconstruction. Many medical problems must be dealt with first. A holistic approach can be used for these problematic conditions. We introduce our experience with the holistic approach for treatment of pressure ulcers. Methods: From July 2014 to October 2016, 42 patients with pressure ulcers underwent treatment with a holistic approach, including teamwork provided by medical and other specialists. We recorded the patient characteristics, methods of surgery and anesthesia, and complications. We also collected data on previous pressure ulcer patients for comparison of treatment effectiveness. Results: Dementia was the only comorbidity that was statistically significant (P = 0.04). However, high odds ratios (ORs) were noted with some comorbidities, such as end-stage renal disease (OR, 16.2), and parkinsonism (OR, 3.10). General anesthesia showed a high OR (12.39) in the holistic group. Regarding the method of surgery, a high OR (13.64) was noted for skin grafting in the control group. All procedures performed in the holistic group consisted of flap surgery. The holistic group had a much greater number of systemic complications, with a high OR (10.48). Conclusions: With the holistic approach, complicated problems may be treated more easily. Management of pressure ulcers is more difficult if there is no good management of underlying medical conditions. We concluded that the holistic approach should be helpful in patients with pressure ulcers.