[Variants in the management of decubitus ulcers]

Decubitus ulcers of the fourth or fifth degree often tend to heal only after years. The result is a bad scar which is unstable and likely to breakdown. It is still surgically correctable, however. The ulcer should be cleaned and after tamponage one should perform excision without opening into the ulcer. Cover can be achieved with either a rotation flap with accompanying muscular padding or a myocutaneous flap. To protect against recurrence, the bone debridement has to be carried out aggressively.