Treating Pressure Ulcers: Surgery
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Remove any tissue that’s not pink or moist.
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Consult with the physician about the need for surgical repair.
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Promote healing and watch for complications after surgery.
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See that the patient’s nutrition is supplemented.
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Advanced ulcers require more aggressive treatment. In addition to cleansing and dressing them, surgically repairing deep ulcers may be necessary. After a pressure ulcer has healed, the area must be protected since it will remain a vulnerable spot.
Surgical Repair
Large wounds are a serious threat to patients. Without surgical repair, they may take a long time to heal, increasing the risk of infection and dehydration.
Surgical Flap
Covering a wound with healthy tissue from another part of the body is an effective way to fill space and provide padding over a bony prominence. Using a muscle or skin flap is one of the best methods, since a flap retains its own blood supply, allowing more rapid healing. A patient undergoing this type of surgery requires anesthesia and may spend time recovering in the hospital while suture lines heal. A skin graft is another type of surgery that can help fill space.
After Surgery
Your role is to keep pressure off the affected area, to keep the sutures clean, and to ensure that wound drains stay open. Watch for signs of infection and hematomas and for signs of improper healing such as a change in color or abnormal drainage.
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Publication Source:
Clark AM, The Osler Medical Handbook, 2nd ed., Management of chronic wounds, Chapter 24, 2006, pp 282-290
Publication Source:
Rakel RE, Conn's Current Therapy 2007, 59th ed., 2007, pp 970-3
Publication Source:
Rehm CR, Siebens H, Essentials of Physical Medicine and Rehabilitation, 1st ed., Pressure ulcers, Chapter 130, 2002, pp 699-704
Online Medical Reviewer:
Trahan, Katherine MD
Date Last Reviewed:
8/2/2004
Date Last Modified:
7/9/2002