Pressure sores--a constant problem for plegic patients and a permanent challenge for plastic surgery

Abstract

Pressure sores can be defined as lesions caused by unrelieved pressure resulting in damage of the underlying tissue. They represent a common problem in the pathology of plegic patients and, plastic surgery has a significant role in their treatment. Pressure sores occur over bony prominences and so, they are most commonly seen at the sacrum and trochanters in paralyzed patients and at ischium for the patients who sit in a wheelchair for a long time. For these patients, surgical treatment is very important because on one hand, it stops the loss of nutrients and proteins at the site of the pressure sore, and on the other hand, it permits the initiation of neuromuscular recuperation treatment much faster.

Figure 1

Skeleton presentation–Common sites of pressure ulcers. The most common sites are the sacrum, greater trochanters, ischial tuberosities, medical and lateral femoral condyles, malleoli and heels. Other sites include the elbows, scapulae, vertebrae, ribs, ears and back of the head.

Figure 2

Sacral sore–preoperative aspect and excision

Figure 3

Sacral sore–Intraoperative aspects–miocutaneous gluteal flap

Figure 4

Ischial sore–preoperative aspect

Figure 5

Ischial sore–intraoperative aspect

Figure 6

Trochanteric sore–preoperative aspect

Figure 7

Trochanteric sore–intraoperative aspects