PRESSURE ULCER-RELATED PELVIC OSTEOMYELITIS: EVALUATION OF A TWO-STAGE SURGICAL STRATEGY (DEBRIDEMENT, NEGATIVE PRESSURE THERAPY AND FLAP COVERAGE) WITH PROLONGED ANTIMICROBIAL THERAPY

Aim A two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitisbut has not been widely evaluated. Method Adult patients with pressure ulcer-related pelvic osteomyelitistreated by a two-stage surgical strategy were included in a retrospective cohort study. Determinants of superinfection(i.e., additional microbiological findings at reconstruction) and treatment failure were assessed using binary logistic regression and Kaplan-Meier curve analysis. Results Sixty-four pressure ulcer-related pelvic osteomyelitisin 61 patients (age, 47 (IQR, 36–63)) were included. Osteomyelitiswas mostly plurimicrobial (73%), with a predominance of S. aureus (47%), Enterobacteriaceae (44%) and anaerobes (44%). Flap coverage was performed after 7 (IQR, 5–10) weeks of NPT, with 43 (68%) positive bone samples among which 39 (91%) were superinfections, associated with a high ASA score (OR, 5...