Operative repair of pressure ulcers.

Surgical management of pressure ulcers ranges from débridement and advancement flap closure for simple ulcers to sensate flaps, expanded flaps, free-tissue transfers, and fillet flaps for more complex ulcers and defects. Some pressure ulcers recur following surgery or conservative treatment, and the surgical options for management of these difficult recurrent ulcers are limited. The geriatric population offers an even more difficult problem as patients suffer invariably from underlying medical and systemic diseases that may affect surgery or the rehabilitation program.