Bilateral gluteal ischemic necrosis mistaken for stage IV pressure wound: case report and discussion.
BACKGROUND
Sacral and gluteal pressure wounds are a common problem in elderly and critically ill patients. Prompt and accurate diagnosis is important to determine the best plan of treatment.


METHODS
A 48-year-old female was hospitalized with severe trunk pain and bilateral necrotic gluteal wounds present for more than 1 year initially diagnosed as stage IV pressure ulcers; she reported pain radiating to her lower extremities. She had multiple comorbid conditions, including peripheral vascular disease, smoking, and hypertension.


CONCLUSIONS
Wound care providers should be aware of this differential diagnosis especially in patients with history of vascular disease.
Richard Simman, MD, FACS, FACCWS, Plastic and Reconstructive Surgery, Department of Pharmacology and Toxicology, Wright State University Boonshoft School of Medicine, Dayton, Ohio. David Reynolds, DPM, Podiatric Medicine and Surgery, Dayton VA Medical Center, Dayton, Ohio.
Richard
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Simman
David
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Reynolds
D002081:Buttocks / Q000293:injuries* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D009336:Necrosis / Q000628:therapy*; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D003668:Pressure Ulcer / Q000628:therapy*; D014945:Wound Healing