The surgical management of pressure ulcers: a systematic approach based on staging.

The surgical management of each of the four stages of pressure ulcers is described. Preoperative management includes vigorous wound care, optimal nutritional status, spasticity control, patient education, and optimal patient physiology. Twelve basic principles of pressure ulcer surgery are presented and illustrated by location of ulcer. Examples include ischial, sacral, greater trochanteric, and lower extremity ulcers.