[Value of surgical treatment of decubitus ulcer in geriatric patients].

Geriatric patients have a high incidence of pressure sores. Pain, chronic and acute infection and protein loss may impair their general condition. Pressure relief, local débridement, disinfection and physiologic wound dressing are the first steps in local treatment. The spontaneous healing time of a pressure sore is very slow, even if concomitant diseases as diabetes, urinary tract infection and pneumonia could be stabilized and the general condition of the patient be improved. In these selected and stable cases, surgical débridement and plastic pressure sore closure may be indicated. Simple skinflaps can give good results in superficial sores without bone involvement and have a low operative morbidity. Musculocutaneous flaps are technically more difficult, but resist better to infection and may fill bigger and deeper defects. In any operation, vascular territories (angiosomes) of further flaps, suitable for a recurrent or second decubitus closure, must be preserved. Long-term results in 30 operated patients over 60 are presented. Although the postoperative complication rate is very high, healing could be achieved in all surviving patients.