Postoperative protocol for flap closure of pressure-induced injury

Time	Protocol
Week 1	Bedrest on air fluidized mattress, 2 hourly turning protocol, head of bed <30 degrees, bowel management (temporary fecal diversion device or constipation), drain management and monitoring
Weeks 2 to 3	Bedrest on air fluidized mattress, 2 hourly turning protocol, head of bed <45 degrees to eat, drain removal, upper body exercises, transfer to rehabilitation facility
Weeks 4 to 8	Progressive sitting program for 1 hour per day, prone rehabilitation, wheelchair and cushion evaluation, domestic evaluation
Weeks 8 to 10	Complete acute rehabilitation and sitting protocol, transition to domestic setting, outpatient physical and occupational therapy, follow-up planning

Courtesy of Alan D Rogers, MBChB, FC Plast Surg, MMed, FRCSI, MSc.

Graphic 129241 Version 1.0