What the future holds for the primary surgical repair as treatment of a massive pressure ulcer?

This is an interesting and well-written case report, representing a novel approach to treat a potentially difficult and complex condition (1). It will be useful to readers belonging to different specialties including plastic surgeons, orthopaedics, geriatricians and tissue viability nurses. It also has highlighted the importance of the basics of wound care and closure by clearly stating the structured, layer by layer closure technique after adequate debridement of the infected tissue (2). Pressure ulcers or injuries are seen predominantly in patients who belong to geriatric group, severely malnourished, paraplegic or neuropathic population. It can also be seen as a consequence of prominent implants/medical devices causing skin pressure. The condition becomes more complex and challenging to manage when it is associated with other comorbidities such as diabetes, infection, immunosuppression and poor tissue perfusion. Overall, pressure ulcer management is an ongoing problem despite the awareness and preventive measures taken globally. Prevalence of the condition up to 10.9% has been reported (3-6)