Prior flap surgery raises complication risk for spinal cord injury patients

Spinal cord injury patients face tough recovery paths. A new analysis of 2566 people from 24 studies looks at what makes healing harder. The goal was to find factors that lead to acute problems or the return of pressure injuries after surgery. The results show that having a prior flap reconstruction before the current surgery is a major red flag. This past surgery nearly five times increased the risk of complications compared to those without it. Diabetes and smoking also linked to higher complication rates. Thoracic injuries carried higher recurrence risks, while cervical injuries seemed to offer some protection against pressure injury returning. The evidence quality varied. Data on diabetes and smoking was low quality, while the flap reconstruction link had moderate quality support. These findings highlight why a multidisciplinary team approach matters so much for preventing the first flap and avoiding repeat procedures.