Recurrence of surgically treated pressure sores

During an 8-year period, 39 patients were referred to our department for surgical treatment of primary pressure sores. They were examined 2-12 years postoperatively in order to demonstrate the incidence of healing or the recurrence rate of pressure sores. Approximately 2/3 of the patients suffered from a neurological disability, inducing impaired sensitivity in the critical skin areas. In our follow-up it was found that 48% of the operated sores recurred--56% occurring in the patients with spinal cord lesions. 48 out of 66 sores healed, but several required more than one operation, and in one patient, as many as four operations had to be performed. The results achieved with musculocutaneous flaps were comparable to those reached by closure with cutaneous flaps. Flaps with intact sensitivity were not used. The time of hospitalization was quite long. As a rule, only one sore was treated at a time. Hence the cost of treatment for these patients is rather high, especially in view of the fact that every second patient will return displaying a new or recurrent pressure sore. It is, therefore most important to inform patients of the continuous risk of a relapse and to analyze his social and psychological environment. Especially, young, neurologically disabled patients need to be made aware of this. A patient treated surgically, whose sores have healed, must stay alert and well in order to avoid recurrence. A psychological study of the patient may be helpful when trying to indicate possible risk groups.