About this resource

Pressure injuries are a serious complication for many people living with spinal cord injury or disorder (SCI/D), with some requiring complex reconstructive flap surgery and lengthy inpatient rehabilitation. While surgery can improve health outcomes, recovery is often challenging, involving prolonged bed rest, gradual rehabilitation and the risk of post-operative complications.

This Hopkins Centre Seed Project explored the factors contributing to complications following flap surgery by combining evidence from published research, clinical data, and the experiences of clinicians and people with lived experience. The findings have informed the development of practical resources to improve care, support shared decision-making and guide best practice for people undergoing flap surgery.

The project was led by Dr Evgeniya Zakharova-Luneva in collaboration with researchers, clinicians and people with lived experience from the Queensland Spinal Cord Injuries Service (QSCIS). The resources below support translation of the research into clinical practice and consumer care.

Project Resources

Consumer Summary Interim Report

This easy-to-read summary provides an overview of the research findings to date. It outlines what the project has learned about complications following flap surgery, why this research is important, and how the findings are being used to improve care for people with spinal cord injury or disorder.

Download the Consumer Summary Interim Report

Flap Surgery Clinical Pathway: Management of Pressure Injuries with Surgical Reconstruction

This co-designed Clinical Pathway was developed using evidence generated through the research together with input from clinicians and people with lived experience. The pathway provides guidance for the management of people undergoing pressure injury reconstruction and supports consistent, evidence-informed care across the rehabilitation journey.

The Clinical Pathway is currently being implemented within the Queensland Spinal Cord Injuries Service and provides a practical framework to support clinical decision-making, improve quality of care, and help patients understand what to expect throughout their admission.

Download the Flap Surgery Clinical Pathway

Conference Poster     

This conference poster presents key findings from the project, highlighting the rates and contributing factors associated with complications following flap surgery in people with spinal cord injury or disorder. The poster was presented at the 2026 Rehabilitation Medicine Society of Australia and New Zealand (RMSANZ) Annual Scientific Meeting and showcases how the research is informing improvements in rehabilitation practice.   

 

 

Download the Project Poster

Project Outcomes

The project has produced important research findings and practical resources that are already supporting improvements in clinical care.

• Better understanding of post-operative complications
  The research identified the range and frequency of complications experienced following flap surgery and examined the surgical, rehabilitation and clinical factors that may contribute to these outcomes. This provides valuable evidence to inform future care and quality improvement initiatives.
• Co-designed clinical guidance
  A practical Clinical Pathway was developed in partnership with clinicians and people with lived experience, ensuring the recommendations reflect both the best available evidence and real-world experiences of recovery following flap surgery. The pathway is now being used within the Queensland Spinal Cord Injuries Service.
• Consumer-focused knowledge translation
  An accessible Consumer Summary Interim Report was developed to share the project's findings with people living with spinal cord injury or disorder, families and the broader community, ensuring the research is available in an easy-to-understand format.
• Research dissemination
  Project findings have been shared nationally through conference presentations, including ANZSCoS 2025 and the RMSANZ 2026 Annual Scientific Meeting, supporting translation of the research into rehabilitation practice.
• Peer-reviewed publication
  The project has produced a peer-reviewed publication describing surgical and rehabilitation outcomes following pressure injury flap surgery in people with spinal cord injury or disorder, contributing new evidence to improve rehabilitation care and inform future research.