Navigating recovery after flap repair for pressure injury in spinal cord injury/disorder: lived experience and clinician perspectives on complications, resilience, and care models.

Abstract

Complex pressure injuries (PIs) in people with spinal cord injury/disorder (SCI/D) often require flap surgery, with high complication rates, extended immobility and prolonged hospitalisation. This study explored the experiences of both people with lived experience of post-flap complications and the multidisciplinary clinicians involved in their care. A descriptive phenomenological qualitative study was undertaken at a specialist Spinal Injuries Unit in Queensland, Australia. Purposive sampling recruited eight participants with lived experience of flap-related complications and ten multidisciplinary clinicians. Data were collected via focus groups and interviews using semi-structured questions, and data were analysed thematically. Three themes emerged: <i>Living in the present, waiting for the future</i>; <i>Negotiating multiple obstacles</i>; and <i>Harnessing purposeful strategies</i>. Participants described prolonged and uncertain recovery characterised by physical, psychological, social, and healthcare challenges, alongside strategies that fostered resilience through specialised multidisciplinary support, self-efficacy, comprehensive preparation and meaningful engagement during recovery. Participants also identified staffing and infrastructure limitations as barriers to optimal care. Recovery after flap repair is complex and multifaceted, requiring specialised SCI/D multidisciplinary care and sustained engagement from individuals. Strengthening preadmission assessment, supporting resilience and wellbeing, and improving models of care may help reduce complications and improve recovery trajectories.