Surgical Repair of Pressure Ulcers

Abstract

A team approach is required for the surgical management of the spinal cord-injured patient with a pressure ulcer, beginning preoperatively with patient selection and preparation, continuing through wound debridement and flap closure, and progressing to rehabilitation and patient education. Although possible surgical complications are numerous and the recurrence rate is relatively high, the surgical management of patients with pressure ulcers can be very rewarding. Goals for surgical closure of pressure ulcers include reduction of protein loss through the wound, reduction of rehabilitation costs, prevention of progressive osteomyelitis, and improvement of patient hygiene. The ultimate reward is the restoration of patients to the rehabilitated sitting position so that they can enjoy productive and happy lives.

Rotation flaps in the treatment of ischial pressure sores – the bigger the better

“…3 Many authors would consider a 16 day hospital admission too short in these circumstances, often employing lengthy graded sitting regimes for 6 weeks or longer. 1,4 In Foster's study 3 however the average hospital stay was only 21 days (16.5 days in those without a complicated past medical history) and was associated with very low recurrence rates.…”