Objective. To determine the surgical management of pressure sores at the National Spinal Injury Hospital and the outcome. Design. This was a four-year prospective study from June 2008 to June 2012. Setting. The study was carried out at the National Spinal Injury Hospital, Nairobi, Kenya. Subjects. Patients with pressure sores operated on during the defined period of study. Results. A total of 46 patients with 58 pressure sores were operated on during the defined period of study. The male？:？female ratio was 10.5？:？1. The mean age was 36.5 years. Trochanteric sores accounted for 60 percent of the pressure sores operated on with the V-Y tensor fascia lata, the commonest surgical procedure, accounting for 37 percent of the procedures performed. At one year of followup 90 percent of the surgeries done were successful with no ulcer recurrence noted. Conclusion. Surgical management of pressure sores even in resource constrained environment would result in faster rehabilitation and early patient discharge. The recurrence of the pressure sores could be greatly reduced by involving patients relatives in the rehabilitation and home-based care. 1. Introduction Pressure sores area is a common problem that spreads across the entire medical field. Prevention is the best way to manage pressure sores. Various pressure dispersion methods are now in use to try and mitigate pressure sores from forming. However, once pressure sores are formed, then one must institute proper wound care management. Many products are now available in the market to assist in pressure ulcer management with each being claimed to provide better results. This is, however, rarely available in many facilities in developing countries like ours. Surgery still remains the cornerstone in the management of the Grades 3 and 4 pressure sores [1]. Majority of the sores seem to concentrate on the pelvic girdle pressure points. Patients with spinal injury are prone to pressure sores formation. One of the biggest challenges in such patients is the recurrence of the pressure sores. To prevent recurrence the use of ripple mattress and home-based nursing care is encouraged. However, in many resource constrained countries the cost of ripple mattresses is way beyond the means of many families. No outreach programs exist to provide home-based care. Many surgical procedures have been described to assist in the closure of the pressure sores. The flaps commonly used are either local or regional flaps that could broadly be classified as either myocutaneous or fasciocutaneous. Most of these flaps are pedicle or axial
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