Surgical repair of pressure ulcers.

A team approach is required for the surgical management of the spinal cord-injured patient with a pressure ulcer, beginning preoperatively with patient selection and preparation, continuing through wound debridement and flap closure, and progressing to rehabilitation and patient education. Although possible surgical complications are numerous and the recurrence rate is relatively high, the surgical management of patients with pressure ulcers can be very rewarding. Goals for surgical closure of pressure ulcers include reduction of protein loss through the wound, reduction of rehabilitation costs, prevention of progressive osteomyelitis, and improvement of patient hygiene. The ultimate reward is the restoration of patients to the rehabilitated sitting position so that they can enjoy productive and happy lives.