Rotation flaps in the treatment of ischial pressure sores--the bigger the better.

Pressure sores are a common problem in paraplegic patients or those otherwise immobilised for long periods of time. Their surgical management is predominantly undertaken by plastic surgeons but other surgeons will also treat them from time to time. We present a case of an ischial pressure sore treated by a general surgeon with a small buttock rotation flap that subsequently broke down with recurrence of the pressure sore. The subsequent surgical management under our care was compromised by his earlier surgery but nevertheless achieved a satisfactory outcome. The need to perform repeat surgery in the future must therefore be borne in mind when planning the initial operation, so that the maximum number of reconstructive options are preserved.