Multiple Ulcers Closed by Multiple Flaps as a Single Procedure
In clinical practice, it is common to evaluate a patient with multiple stage IV ulcers. Multiple ulcers are defined as clinical manifestations of more than two pressure ulcers. Patients with multiple ulcers commonly have a primary diagnosis of insensate secondary to spinal cord injury or advanced neurologic disease. The plastic surgeon with limited exposure in this field faces a challenge in the approach to repairing these ulcers, whether to close one or two ulcers at a time or all at one time. The choice depends on experience and the exposure in this field. For this reason, the author considers this subject important, and the plastic surgeon requires exposure to the concept of management of multiple ulcers in one stage. In this chapter, the discussion focuses mainly on the advantages and disadvantages of this practice based on a review of the literature and the author’s experience in this surgical practice.
KeywordsSpinal Cord Injury Pressure Ulcer Plastic Surgeon Urinary Diversion Vastus Lateralis Muscle