Early results of operative closure of pressure sores in traumatic paraplegics.

The development of pressure sores in the course of management of a paraplegic represents a major setback which will not only delay rehabilitation but prolong hospital stay. Pressure sores may heal under conservative management provided the site is relieved of pressure. This mode of treatment is associated with prolonged immobilisation and is accompanied by a higher incidence of recurrence. Since in our unit pressure sores are mostly closed with flaps, we decided to review our early results. Between 1981 and 1986, 28 patients with 61 pressure sores were surgically closed at the National Orthopaedic Hospital, Enugu, Nigeria. The 29 trochanteric sores were closed with tensor fascia lata (TFL) myocutaneous flap. Sacral sores were closed with bilateral gluteal flaps or a rhomboid flap. Most ischial sores were closed with gracilis myocutaneous flap. Overall 72.1% of our cases healed primarily with no complications. There were 3 major complications requiring reoperation and 14 minor complications which healed on conservative management with daily dressing. We conclude that operative closure of pressure sores in traumatic paraplegics is advocated as this affords the greatest benefit to the patients.