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

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Published 1st September 2026

Purpose
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.

Materials and Methods
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.

Results
Three themes emerged: Living in the present, waiting for the future; Negotiating multiple obstacles; and Harnessing purposeful strategies. 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.

Conclusion
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.

IMPLICATIONS FOR REHABILITATION 

Following flap repair for spinal cord injury/disorder-related pressure injuries, major physical and psychological impacts occur in the postoperative rehabilitation phase. People with spinal cord injury/disorder should be advised that postoperative complications and unexpected obstacles are common and often delay discharge. Postoperative psychosocial rehabilitation should focus on assisting with boredom and social isolation, uncertainty and setbacks, and loss of autonomy. Models of care that promote self-efficacy and self-management with the support of the specialist clinical team are likely to be most effective.

Citation

Zakharova-Luneva, E., Burridge, L., Hogan, C., Kemp, J., Meyers, D., Rixon, K., & Geraghty, T. (2026). Navigating recovery after flap repair for pressure injury in spinal cord injury/disorder: Lived experience and clinician perspectives on complications, resilience, and care models. Journal of Mental Health. 

Authors

Letitia Burridge

Tim Geraghty

Professor and Director

Christy Hogan

Research Fellow

Evgeniya Zakharova-Luneva

Rehabilitation Medicine Physician