Surgical management of decubitus ulcers

Decubitus ulcers are a significant source of morbidity and mortality in those populations affected^1-3: the elderly, the neurologically impaired, and paraplegics. Health care expenditures rise because of the increased length of hospital stay for patients with pressure ulcers. Treatment modalities and staffing time are increased considerably with the management of pressure ulcers both in the United States^1,4 and abroad.⁵ The magnitude of the decubitus ulcer problem has been compared to an epidemic in the British literature,⁵ and it is considered a serious public health concern by authorities in the United States.^4,6. The literature abounds with reviews focusing on the epidemiology, etiology, pathophysiology, risk factors, prevention, and treatment of decubitus ulcers.^5-12 These aspects are addressed in this article to provide a clear understanding of the populations at risk for developing decubitus ulcers and of those pathophysiologic factors responsible for their development. Subsequently, preventive measures, management, and treatment modalities are discussed.