Abstract
Several surgical modalities are available for closing ischial pressure wounds, but while they all aim for a permanently closed and well-padded ischial area, the manner in which this objective is achieved is different for each operation. Each technique has its unique design, transposes variable amounts and quality of soft tissue, and creates different scars and donor defects. These factors, in return, influence to a considerable extent the durability of each operation and, more important, create scars that dictate the nature of the secondary surgery in the all too common event of recurrent ulceration. No tissue is immune to pressure, and therefore there is no one best operation for closing pressure ulcers. This article critically reviews and updates contemporary surgical management and presents an orderly approach to selecting an operation for closing ischial pressure ulcers.
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