Rotation flaps in the treatment of ischial pressure sores - the bigger thebetter

Pressure sores are a common problem in paraplegic patients or those otherwi se immobilised for long periods of time. Their surgical management is predo minantly undertaken by plastic surgeons but other surgeons will also treat them from time to time. We present a case of an ischial pressure sore treat ed by a general surgeon with a, small buttock rotation flap that subsequent ly broke down with recurrence of the pressure sore. The subsequent surgical management under our care was compromised by his earlier surgery but never theless achieved a satisfactory outcome. The need to perform repeat surgery in the future must therefore be borne in mind when planning the initial op eration, so that the maximum number of reconstructive options are preserved .