Surgical correction of pressure ulcers in an urban center: is it efficacious?

Recurrence following surgical correction of pressure ulcers remains one of the more formidable complications of their treatment. To assess the effect of surgical therapy on recurrence, thirty patients were evaluated between 1985 and 1990 at The Johns Hopkins Hospital. These data were compared to a prior study conducted from our institution between 1977 and 1980. Follow-up in this current study ranged from 1-108 months. Of the 22 paraplegic patients, pressure ulcers recurred at the same site of surgical correction in 82 percent (n = 18), or at a different site in 64 percent (n = 14), at an average of 18.2 and 20.2 months respectively. No recurrence was noted in the eight non-paraplegic patients. In an urban center, surgically corrected pressure ulcers have a high recurrence. Physician and patient must be willing to accept a high recurrence rate prior to attempted surgical closure.