REDUCING THE PERIOD OF IMMOBILIZATION FOLLOWING PRESSURE SORE SURGERY- A PROSPECTIVE, RANDOMIZED TRIAL

The cost to care for a patient with pressure sores can be exorbitant. One part of this expense results from the prolonged postoperative immo bilization. Published protocols report 3 to 8 weeks of immobilization; however, there are no studies that establish longer periods to be sup erior. To justify our 3-week protocol, we conducted a prospective rand omized trial of 2 versus 3 weeks of postoperative immobilization. Each patient was randomized preoperatively to either 2 or 3 weeks of posto perative immobilization. A total of 42 patients with a diagnosis of pa raplegia, tetraplegia, or multiple sclerosis and a solitary pressure s ore were enrolled over 5 years. The complication rates in the two grou ps (9 of 23. or 39 percent, for the 2-week group and 9 of 19, or 47 pe rcent, for the 3-week group) were not statistically different (p < 0.4 93). However, the time to mobilization was significantly reduced in th e 2-week group (16.1 +/- 6.1 versus 22.9 +/- 4.9 days, p < 0.0003), as was the time to achieve sitting (21.2 versus 28.9 days, p < 0.0026). In summary, 2 weeks of postoperative immobilization following surgery is adequate for uncomplicated solitary pressure sores.