{
    "abstract": "A left ventricular assistance device (LVAD) is indicated in patients with end-stage heart failure. Due to the non-physiologic blood flow, a LVAD may favor pressure sores with a devastating risk of infection. This work shows the prevalence and treatment of pressure sores in LVAD patients, to optimize their management.\nWe retrospectively investigated all LVAD implantations at the Lausanne University Hospital (CHUV) from 2015 to 2019. We detected patients who developed a pressure sore and evaluated the timeline, management, and outcomes.\nForty-two patients benefited from LVAD, among whom 5 (12%) developed a stage III/IV pressure sore, within a mean time of 25 days. Due to their poor overall condition, 4/5 patients were treated surgically and 1/5 conservatively. Half of the patients treated with surgery had major complications requiring reoperation. After flap coverage, the mean time to healing for patients was 6 weeks.\nThe rapid development of deep pressure sores seen in 12% of patients may be a manifestation of the maladaptive blood flow induced by LVADs, combined with their bedridden condition. Initial signs of pressure sores should be considered seriously, as they are rapidly evolving and needing an aggressive surgical treatment whenever possible (80%). Complication rate was similar compared to standard pressure sore flap treatment. All patients benefiting from flap surgery achieved effective coverage after a mean follow-up of 24 months. No patient developed a LVAD infection.\nSurgery must be considered early in this population to prevent potential device infection.",
    "authors": [
        {
            "affiliation": "Plastic, Reconstructive and Hand Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, Lausanne 1006, Switzerland.",
            "firstname": "Clara",
            "initials": "C",
            "lastname": "Schaffer"
        },
        {
            "affiliation": "Cardiac Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.",
            "firstname": "Ziyad",
            "initials": "Z",
            "lastname": "Gunga"
        },
        {
            "affiliation": "Plastic and Reconstructive Surgery, Dijon University Hospital (CHU Dijon), Dijon, France.",
            "firstname": "David",
            "initials": "D",
            "lastname": "Guillier"
        },
        {
            "affiliation": "Plastic, Reconstructive and Hand Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, Lausanne 1006, Switzerland.",
            "firstname": "Wassim",
            "initials": "W",
            "lastname": "Raffoul"
        },
        {
            "affiliation": "Cardiac Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.",
            "firstname": "Matthias",
            "initials": "M",
            "lastname": "Kirsch"
        },
        {
            "affiliation": "Plastic, Reconstructive and Hand Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, Lausanne 1006, Switzerland. Electronic address: pietro.di-summa@chuv.ch.",
            "firstname": "Pietro G",
            "initials": "PG",
            "lastname": "di Summa"
        }
    ],
    "conclusions": "Surgery must be considered early in this population to prevent potential device infection.",
    "copyrights": "Copyright \u00a9 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.",
    "doi": "10.1016/j.bjps.2022.11.029",
    "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS",
    "keywords": [
        "Gluteal flap",
        "LVAD",
        "Left ventricular assistance device",
        "Lumbosacral reconstruction",
        "Pressure sore"
    ],
    "methods": null,
    "publication_date": "2023-01-12",
    "pubmed_id": "36628855",
    "results": "Forty-two patients benefited from LVAD, among whom 5 (12%) developed a stage III/IV pressure sore, within a mean time of 25 days. Due to their poor overall condition, 4/5 patients were treated surgically and 1/5 conservatively. Half of the patients treated with surgery had major complications requiring reoperation. After flap coverage, the mean time to healing for patients was 6 weeks.",
    "title": "Pressure sore incidence and treatment in left ventricular assist device (LVAD)-equipped patients: Insights from a prospective series.",
    "xml": "<Element 'PubmedArticle' at 0x788503c34900>"
}