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Pressure Ulcers and Perineal Reconstruction

Larson, Jeffrey D. M.D.; Altman, Andrew M. M.D.; Bentz, Michael L. M.D.; Larson, David L. M.D.

Plastic and Reconstructive Surgery: January 2014 - Volume 133 - Issue 1 - p 39e–48e
doi: 10.1097/01.prs.0000435843.87927.90
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Learning Objectives: After reading this article, the participant should be able to: 1. Discuss the approach and rationale of pressure sore management, including specific techniques of bone biopsy and postoperative care resulting in a significant reduction in recurrence rates. 2. Develop a surgical plan for reconstructing defects of the perineum, taking into account the local tissue factors and the soft-tissue requirements for reconstruction.

Summary: As close as the buttocks and the perineum are anatomically, the clinical settings and the solutions to wound problems in these areas are quite different. The ubiquitous “pressure ulcer” presents more commonly as a clinical management problem than a reconstruction issue. On the other hand, the perineal defect is almost always a reconstruction challenge following tumor ablation. For these reasons, the authors have chosen to separate this Continuing Medical Education offering into two parts. The first part addresses the pressure ulcer, while the latter discusses the perineum.


Madison and Milwaukee, Wis.

From the Department of Plastic Surgery, University of Wisconsin Medical School; and Department of Plastic Surgery, The Medical College of Wisconsin.

Received for publication June 12, 2012; accepted July 30, 2012.

Disclosure: The authors have no associations or financial disclosures to report.

Related Video content is available for this article. The videos can be found under the “Related Videos” section of the full-text article, or, for Ovid users, using the URL citations published in the article.

Jeffrey D. Larson, M.D., Department of Plastic Surgery, Medical College of Wisconsin, 8700 Watertown Plank Road, Milwaukee, Wis. 3226–3595,

©2014American Society of Plastic Surgeons