Healing an ischial tuberosity pressure ulcer in a patient with neurogenic heterotopic ossification: a case report.
J Wound Care
; 33(Sup3a): lxix-lxxiii, 2024 Mar 01.
Article
en En
| MEDLINE
| ID: mdl-38457272
ABSTRACT
Neurogenic heterotopic ossification (NHO) is widely recognised as an aberrant bone formation in soft tissue following central nervous system injury. It is most frequently associated with pain and limited movement, especially in the hip. However, it may be neglected in patients with paraplegia with a pressure ulcer (PU). We report the case of an 18-year-old male patient who presented with a hard-to-heal ischial tuberosity PU and who had undergone three operations at other hospitals during the previous six months, which had failed to repair the PU. There was a history of paraplegia as a consequence of spinal cord injury two years previously. Computed tomography and three-dimensional reconstruction showed massive heterotopic ossification (HO) in the wound bed and around the right hip. Histological findings were consistent with a diagnosis of HO. The HO around the wound was completely excised, negative pressure wound therapy was used to promote granulation, and a gluteus maximus musculocutaneous flap was used to cover the wound. We conclude that for patients with paraplegia, with a hard-to-heal PU, it should be determined whether it is associated with NHO. Surgical resection of HO surrounding the wound and improving the microcirculation are critical for repair and reconstruction of these PUs.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Traumatismos de la Médula Espinal
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Osificación Heterotópica
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Úlcera por Presión
Límite:
Adolescent
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Humans
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Male
Idioma:
En
Revista:
J Wound Care
Asunto de la revista:
ENFERMAGEM
Año:
2024
Tipo del documento:
Article