ABSTRACT
Despite the numerous surgical procedures described for treatment of pressure ulcers, surgical flap coverage has not been established as the gold standard of therapy for pressure ulcers. Proper patient education, social support, dedicated wound care, and ulcer prevention are considered more important in achieving complete healing. Unfortunately, these aspects of care can require tremendous healthcare resources and are often not feasible, thereby necessitating a flap. In addition, pressure ulcers involving bonemay not heal without surgical closure, and conservative care may take months to achieve healing. In this context, flap closure often becomes an important adjunct to therapy. Flap coverage, however, is plagued by a substantial initial failure rate and an extremely high recurrence rate, with some studies indicating recurrence rates as high as 60-80%. With no consistently effective treatment other than prevention, pressure ulcers represent a considerable morbidity in certain patient populations and a significant economic burden. As a result, the plastic surgeon should have an influential role in the medical community treating this challenging multidisciplinary problem.
I. ETIOLOGY
