eMedicine Specialties > General Surgery > Abdomen

Decubitus Ulcers: Follow-up

Author: Don R Revis Jr, MD, Consulting Staff, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine
Contributor Information and Disclosures

Updated: Aug 27, 2009

Outcome and Prognosis

Achieving a closed wound is the beginning of a lifelong struggle to prevent recurrent ulceration at the surgery site or at a new site. Recurrence rates in the literature are reported to be as high as 90%.

Future and Controversies

Promising research in the field of growth factors and wound healing has shed light on the complex interactions that ensue at the wound surface and in the affected organism as a whole. This has led to the introduction of becaplermin (Regranex), recombinant human platelet-derived growth factor. This topical agent has been approved by the US Food and Drug Administration (FDA) for the treatment of lower extremity, diabetic neuropathic ulcers that extend into the subcutaneous tissue or beyond. Studies are underway to possibly expand the approved indications for this drug to include other wounds. Other growth factors also are being evaluated for use in human clinical settings. This expanding field surely will contribute further applications of basic science to clinical wound healing, with improvement of our understanding and patient care.

Ethical considerations

As a final note, one should consider the ethics of pressure sore treatment. The aggressive treatment of pressure ulceration is outlined in this article. This treatment certainly is indicated for one subset of patients who have pressure ulceration, that is, acutely hospitalized patients with a recoverable illness.

For other persons, such as chronically or terminally ill patients with long-standing or recurrent ulceration, aggressive treatment may not be in their best interests. In these instances, the wishes of the patient or the patient's family should be weighed carefully. In many cases, medical care and the maintenance of patient comfort, rather than the institution of major invasive procedures, should be the goals.

 


More on Decubitus Ulcers

Overview: Decubitus Ulcers
Workup: Decubitus Ulcers
Treatment: Decubitus Ulcers
Follow-up: Decubitus Ulcers
Multimedia: Decubitus Ulcers
References
Further Reading
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References

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Keywords

decubitus ulcer, decubitus, pressure ulcer, pressure ulcers, bed sores, bed sore, pressure sore, pressure sores, bedsores, diabetic ulcer, decubitus ulcers, pressure ulcer staging, decubitus sore, ischial tuberosity ulcer, bed ridden, bedridden, bed rest injury, bedrest injury, chronic ulceration, pressure ulceration, decubitus ulceration

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Contributor Information and Disclosures

Author

Don R Revis Jr, MD, Consulting Staff, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine
Don R Revis Jr, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, and American Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Alex Jacocks, MD, Program Director, Professor, Department of Surgery, University of Oklahoma School of Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Michael A Grosso, MD, Consulting Staff, Department of Cardiothoracic Surgery, St Francis Hospital
Michael A Grosso, MD is a member of the following medical societies: American College of Surgeons, Society of Thoracic Surgeons, and Society of University Surgeons
Disclosure: Nothing to disclose.

CME Editor

Paolo Zamboni, MD, Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy
Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences
Disclosure: Nothing to disclose.

Chief Editor

John Geibel, MD, DSc, MA, Vice Chairman, Professor, Department of Surgery, Section of Gastrointestinal Medicine and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital
John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract
Disclosure: AMGEN Royalty Other

 
 
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