A 12-Month Retrospective Review of Pressure Injury Plastic Surgical Flap Techniques Utilizing Pure Hypochlorous Acid (pHA) Preserved Wound Solution for Wound Bed Preparation

Background: The presence of heavy microbial colony formation, polymicrobial infection, and local altered pH contribute to the high rate of postoperative complications following surgical reconstruction of stage IV pressure injuries (PIs). Purpose: The objective of this study was to determine the rate of bacteria-related postoperative complications following surgical reconstruction of stage IV PIs in which a pure hypochlorous acid (pHA) antimicrobially preserved wound cleaning solution was used. Methods: This 1-year retrospective review evaluated the outcomes of patients who underwent surgical reconstructive treatment of chronic stage IV PI. Surgical management consisted of wide debridement, intraoperative cultures, and irrigation with 8 to 10 minutes indwelling of a pHA antimicrobially preserved wound cleaning solution prior to closure and application of incisional negative pressure wound therapy (iNPWT). Results: Thirteen patients (18 chronic, stage IV PIs) were included in the study. Intraoperative cultures were positive for 10/18 wounds (55.6%). A bacteria-related postoperative complication occurred in 1 patient (1/13, 7.7%; postoperative dehiscence requiring reoperation). Conclusions: Adjunctive irrigation and indwelling of a pHA antimicrobially preserved wound cleansing solution in the surgical management of chronic, stage IV PIs in this 1-year retrospective review resulted in a 7.7% bacteria-related postoperative complication rate.