title: [Surgical treatment of a long-term decubitus ulcer].
abstract: A 64-year-old male presented with a large decubitus ulcer of the sacrum which had not healed for thirteen years in spite of various conservative treatments. His primary disease was paraplegia following spondylitis. Although he was not ambulatory, he was able to manage a wheelchair. The decubitus, which had a 8 x 13 cm dead space, was successfully closed with a single operation using two fasciocutaneous flaps. The patient was discharged two months postoperatively. The medical cost of his treatment before and after the surgery was investigated. The expense including the surgery and postoperative care until discharge was five times more than the monthly cost of the preoperative period. These findings suggest that a decubitus ulcer which does not respond to conservative treatments for more than several months should be considered for a surgical management, as long as the patient's general condition permits an operation.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Nagoya University School of Medicine.
authors.forename: K
authors.initials: K
authors.lastname: Toriyama
authors.forename: S
authors.initials: S
authors.lastname: Torii
authors.forename: M
authors.initials: M
authors.lastname: Hasegawa
authors.forename: T
authors.initials: T
authors.lastname: Okada
authors.forename: N
authors.initials: N
authors.lastname: Okuda
authors.forename: Y
authors.initials: Y
authors.lastname: Tachi
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D005205:Fascia / Q000637:transplantation; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D003668:Pressure Ulcer / Q000191:economics / Q000601:surgery*; D016038:Skin Transplantation; D013524:Surgical Flaps