Management of pressure sores in a specialty center. A reappraisal.

We report a study on the surgical management of 145 pressure sores in 115 patients treated in a spinal cord injury center. There is a definite trend toward better education of these patients, who do not develop their first pressure sores until years following the injury. When the patient comes in for an ulcer, he is usually healthy and the ulcer is small and clean. In such instances the ulcer can be excised and closed, preferably with a myocutaneous flap, and the patient can usually begin sitting by the 21st post-operative day. In the ideal setting he may be discharged to his home on a custom-fitted (for pressure) cushion within 4 to 5 weeks, without increasing the risk of recurrence. Prophylaxis for the future is, probably, the most essential part of the treatment.