OPERATED PRESSURE ULCERS IN THE SPINAL CORD INJURED PATIENTS
H. Yilmaz, N. Kesiktas, S. Yaman, G. Demitel,: Istanbul Physical Med. & Rehab. Centre, Istanbul, Turkey
Purpose: For evaluation of our success in SCI patients we research operated pressure ulcers and patients data.
Methods: 52 SCI patients with an operated pressure ulcer, range 16-64 were included in this study. We evaluated demographic features, risk factors and therapy.
Results: 22 patients have multiple pressure ulcers. Sacral sores predominated followed by throchantric sores. Cervical injured people have more than 1 localization of pressure ulcer for the other levels, (p<0.01). 44,2% pressure sores are third degree (settled to the bone). 90,38% operated pressure ulcers had good results. 55,7% myocutaneous flaps are used. Risk factors are fecal incontinance, urine incontinance, anemia, spasticity, immobility, completeness of the SCI, lesion level, prolonged immobilization immediately after SCI. There is a statistic significance between being a pressure ulcer (in the first month of SCI and later), beginning to rehabilitation time (in the first month and after) chi-square=7,07 (p<0,01). 3,8 % patients died after operation and 5,8% send reanimation centre, these patients came from home, they had no social and economic support and no rehabilitation at home.
Conclusion: Patients must controlled at home environment too.
"REHABILITATION OF PREGNANCY RELAYED NEOPLASMS"
Naseem A. Shekhani, MD (Rush University; Chicago, IL; U.S.A.)
V. Stambolis, MD (Rush university; Chicago, IL; U.S.A.)
During pregnancy, spinal cord neoplasm (SCN) is a rare condition. These neoplasms may become symtomatic for the first time during pregnancy. Different neoplasms are seen at different trimesters of pregnancy, and many of them are harmone dependent. Pregnancy related SCN have a wide range of symptomatology. We present three cases of pregnancy related SCN; of which two of them meningioma and one with ependymoma. All of these patients were seen with an initial presentation of back pain and subsequently had a motor and sensory deficits antepartum. Diagnosis were established antepartum by magnetic resonace imaging, all the three deliveries were uneventful. Neoplasms were resected and laminectomies were performed postpartum. The patients were admitted at the comprehensive inpatient rehabilitation for their neurological deficits. All three patients improved significantly and had upgraded in their functional level in all the rehabilitation disciplines, especially in activities of daily living and ambulating with ankle foot orthosis. On follow-up visits all three patients were independent ambulators with adaptive equipments and orthotics.
Physiatrist should be aware of growth characteristics, pathology, medical and surgical treatment of SCN during pregnancy. A carefully orchestrated rehabilitation is needed during antepartum, parturation and post-partum. Excellent prognosis is predicted with early rehabilitative interventions.