ISSN: 2375-3838
International Journal of Clinical Medicine Research  
Manuscript Information
Surgical Treatment of Decubital Ulceration - Our Clinical Experience
International Journal of Clinical Medicine Research
Vol.7 , No. 1, Publication Date: Jan. 10, 2020, Page: 6-9
2395 Views Since January 10, 2020, 451 Downloads Since Jan. 10, 2020

Maksimovic Sinisa, Public Health Institution Hospital "Sveti Vracevi", Department of General Surgery in Bijeljina, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.


Introduction: Decubital ulceration is a tissue defect resulting from the soft tissue necrosis at the point of their compression between bone prominence and the surface of the body support over an extended period of time. Decubitus occurs most often in hospitals (about 60%), nursing homes and other long-term care facilities are second, while 9% to 20% of decubitus occurs in home care patients. Patients and methods: In the period 2000-2009, 36 patients with 44 decubital ulceration were treated at the Department of general surgery of General Hospital in Bijeljina. Surgical treatment of decubital ulceration is associated with the degree of damage to deep bone structures (sacral bone, sciatic bone, femur). More than one operation was performed in six patients. Results: Nearly 90% of our patients had lower-body decubitus. Surgical treatment of decubital wounds consists of: radical trimming of devitalized tissues, bursa and removal of heterotopic calcification, partial or complete osteotomy of bone prominences, and closure of the defect with well-vascularized, soft, local, skin, or muscular lobes. In addition to surgical treatment, conservative treatment measures have been implemented in patients; redistribution of pressure in critical areas, daily body hygiene, regular changing of bedding, wound disinfection with antiseptic, application of various dressings and topical medicines, electromagnetic therapy, ultrasound therapy, Vac therapy. The most common complications were infections, partial hepatic necrosis, and dehiscence. Conclusion: The surgical treatment of decubital ulceration requires good preoperative care, a clear preoperative plan and teamwork. Postoperative care is of great importance and must include trained medical staff as well as a professional team for physical rehabilitation.


Decubital Ulceration, Surgical Treatment, Therapy


European Pressure Ulcer Advisory Panel. Pressure ulcer prevention guidelines.


Cullum N, Buckley H, Dumville J, Hall J, Lamb K, Madden M, et al. Wounds research for patient benefit: a 5-year programme of research. Programme Grants Appl Res 2016; 4 (13).


Jones RE, Foster DS, Longaker MT, Management of Chronic Wounds-2018 JAMA. 2018; 320 (14): 1481-1482. doi: 10.1001/jama.2018.12426.


Tripathi R, Knusel KD, Ezaldein HH, Honaker JS, Bordeaux JS, Scott JF. Incremental Health Care Expenditure of Chronic Cutaneous Ulcers in the United States. JAMA Dermatol. 2019; 155 (6): 694–699. doi: 2018. 5942.


Tashiro J, Gerth DJ, Thaller SR. Pedicled Flap Reconstruction for Patients With Pressure Ulcers: Complications and Resource Utilization by Ulcer Site. JAMA Surg. 2016; 151 (1): 93–94. doi:


Wong JK, Amin K, Dumville JC. Reconstructive surgery for treating pressure ulcers. Cochrane Database Syst Rev. 2016; 12 (12): CD012032. Published 2016 Dec 6. doi: 10.1002/14651858.CD012032.pub2.


Pressure relieving devices. Clinical guidelines. 2003. Pressure ulcer management. Clinical guidelines. 2005


Cherry GW, Hughes MA, Ferguson MWJ, Leaper DJ. Wound healing. In: Morris DJ, Woods WC, eds. Oxford textbook of surgery. 2nd ed. Oxford: Oxford University Press, 2001.


Clark RAF. The molecular and cellular biology of wound repair. 2nd ed. New York: Plenum Press, 1998.


Bamba R, Madden JJ, Hoffman AN et al. Flap Reconstruction for Pressure Ulcers: An Outcomes Analysis, Plastic & Reconstructive Surgery Global Open, Jan 1, 2017, DOI: 10.1097/GOX.0000000000001187.


Preventing Pressure Ulcers in Hospitals. Rockville, MD: Agency for Healthcare Research and Quality; September 2012 (content last reviewed October 2014). Available at: Accessed June 1, 2016.


Glat PM, Longaker MT. Wound healing. In: Aston SJ, Beasley RW, Thorne CHM, eds. Grabb and Smith’s plastic surgery. 5th ed. Philadelphia, PA: Lippincott- Raven, 1997.


Brem H, Lyder C. Protocol for the successful treatment of pressure ulcers. Am J Surg 2004; 188 (Suppl 1A): 9-17.


Cullum N, McInnes E, Bell-Syer SE, Legood R. Support surfaces for pressure ulcer prevention. Cochrane Database Syst Rev 2004; (3): CD00173.


Panajotović L, Kozarski J, Cvetanović S. Hirurško lečenje dekubitusa. 2017, Klinika za plastičnu hirurgiju i opekotine Vojnomedicinske akademije u Beogradu, Serbija.

  Join Us
  Join as Reviewer
  Join Editorial Board