Cairo Plastic Clinic 

Pressure ulcers, also known as decubitus ulcers or bedsores, are localized injuries to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. Most commonly this will be the back, coccyx, heels or the hips, but other sites such as the elbows, knees, ankles or the back of the head can be affected.

The cause of pressure ulcers is pressure applied to soft tissue so that blood flow to the soft tissue is completely or partially obstructed. Shear is also a cause; shear pulls on blood vessels that feed the skin. Pressure ulcers most commonly develop in persons who are not moving about or are confined to wheelchairs.

It is widely believed that other factors can influence the tolerance of skin for pressure and shear thereby increasing the risk of pressure ulcer development. These factors are protein-calorie malnutrition, skin wetness caused by sweating or incontinence, diseases that reduce blood flow to the skin, such as arteriosclerosis or diseases that reduce the feeling in the skin, such as paralysis or neuropathy. The healing of pressure ulcers may be slowed by the age of the person, medical conditions (such as arteriosclerosis,diabetes or infection), smoking or medications such as antiinflammatory drugs.

Bed sores once developed need surgical intervention. The necrotic tissue which is usually deep and extensive, forming a cave-like structure  must be removed totally. Then new tissue with fresh blood supply in the form of a flap is brought to cover the damaged area. Dr. Wilson prefers doing both procedures in one stage to shorten the healing time, but some resistant cases might be done in two stages.

Bed Sore in the left thigh (trochanter): This 59 year old female with diabetes and hemiplegia had a deep bedsore in the left thigh. In one stage, Dr. Wilson removed the necrotic tissue and covered it by healthy skin.

Bed Sore in the Back (presacral): This 69 year old male with long standing disability had a deep extensive bedsore in the lower back. In one stage, Dr. Wilson removed the necrotic tissue and covered it by a healthy gluteal flap.

Bed Sore in the Back (presacral): This 79 year old female with long standing disability had a deep extensive bedsore in the lower back. In one stage, Dr. Wilson removed the necrotic tissue and covered it by healthy skin.

Bed Sore in the Back: This 32 year old male with a deep bedsore in the left upper back had a surgery to remove the sore and cover it by a large flap from the back.

Bed Sore in the Back: This 72 year old female with a deep bedsore in the lower back had a major surgery to remove the sore and cover it by a large flap from the back.

Extensive Gangrenous Sores in the Back and Thigh: This 42 year old male with deep gangrenous sores in the lower back and Thighs had a major surgery to remove the sore and then cover it by a large skin graft. 

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