[Plastic surgery coverage of pressure ulcers of the trunk and pelvic region]

Decubitus ulcers develop due to pressure on tissue resulting in decreased perfusion of the affected region. Areas with bony prominences are mainly affected. At risk are immobile patients or patients with limited mobility as well as people with sensitivity disorders. Patients in advanced age are more endangered than younger ones regarding the development of pressure ulcers and this patient population usually presents with a combination of extrinsic and intrinsic risk factors; therefore, prevention and treatment of extensive tissue lesions are a particular multidisciplinary challenge with high socioeconomic significance in respect to the demographic change with an increasing proportion of elderly people. Surgical treatment is of special importance for extensive lesions and unstable scar tissue formation. In addition to invasive wound cleaning by lavage, debridement and bacterial decontamination, procedures with local and regional tissue transfer are given priority for permanent coverage of skin defects. Free tissue flap techniques are also established but are less commonly used. Nutrition, complication management and positioning of the patient are mandatory additional measures for improved outcome.