{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T17:01:21Z","timestamp":1772038881472,"version":"3.50.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"51","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12,22]]},"abstract":"<jats:sec>\n            <jats:title>Rationale:<\/jats:title>\n            <jats:p>Pressure ulcers are a common health issue, particularly among elderly and bedridden patients who are vulnerable to pressure injuries in the sacral region. Currently, free flap and local flap surgeries are the gold standard procedures for the reconstruction of such injuries. However, the recurrence rate of flap surgery appears to be high. In this context, we presented a case involving a sacral pressure ulcer reconstructed with dermal grafting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient concerns:<\/jats:title>\n            <jats:p>A 59-year-old male with a medical history of hepatitis C, brain hemorrhage, hydrocephalus, and multiple fractures presented with a sacral ulcer. Owing to the patient\u2019s history of recurrent pressure injuries and the challenges associated with postoperative wound care, the patient and his family were hesitant to proceed with flap surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Diagnoses:<\/jats:title>\n            <jats:p>The patient was diagnosed with a stage IV pressure ulcer measuring 4 cm\u2005\u00d7\u20054\u2009cm in size in the sacral region, according to the National Pressure Ulcer Advisory Panel staging system.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions:<\/jats:title>\n            <jats:p>Before surgery, the patient received standard wound care with dressing for 4 months, along with short-term oral antibiotics due to a positive wound culture for <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>. During the surgery, a dermal graft with a size of 35\u2009cm<jats:sup>2<\/jats:sup> and a thickness of 0.014 inches was harvested from the patient\u2019s left thigh. The graft was then secured to the wound bed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcomes:<\/jats:title>\n            <jats:p>Although the dermal graft failed with sloughing after 1 week, the wound bed showed improvement with granulation. After 1.5 months, the wound area had decreased to half of its original size, and the wound eventually healed after 3.5 months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Lessons:<\/jats:title>\n            <jats:p>Dermal grafts have a niche in reconstructing pressure injury wounds in the sacral region, because of the relative ease of wound care and additional benefits even in cases where the graft fails.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000036617","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T19:01:47Z","timestamp":1703271707000},"page":"e36617","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["The niche of dermal graft to reconstruct a complex pressure injury wound in sacral region: A case report"],"prefix":"10.1097","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6092-2711","authenticated-orcid":false,"given":"Te-Wei","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of General Medicine, Taipei Medical University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7286-7928","authenticated-orcid":false,"given":"Yun-Nan","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan"},{"name":"School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su-Shin","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yur-Ren","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250503","doi-asserted-by":"crossref","first-page":"661","DOI":"10.7326\/0003-4819-94-5-661","article-title":"The pressure sore: pathophysiology and principles of management.","volume":"94","author":"Reuler","year":"1981","journal-title":"Ann Intern Med"},{"key":"R2-20250503","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/j.jaad.2018.12.069","article-title":"Pressure ulcers: pathophysiology, epidemiology, risk factors, and presentation.","volume":"81","author":"Mervis","year":"2019","journal-title":"J Am Acad 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