Bed sores, also known as pressure ulcers or decubitus ulcers, are areas of skin and underlying tissue damage that occur due to prolonged pressure, especially in immobile or bedridden patients. These wounds most commonly affect bony areas such as the back, hips, buttocks, and heels, and can become deep, infected, and difficult to heal without specialized care.
Dr. Ravi Saroha, an experienced plastic and reconstructive surgeon in Delhi, offers comprehensive treatment for all stages of bed sores—from early intervention to surgical reconstruction of advanced wounds.
Bed sores develop when constant pressure restricts blood flow to certain areas of the body. Contributing factors include:
When a pressure ulcer becomes deep, chronic, or fails to heal with conservative measures, surgical intervention becomes necessary. The goal of surgery is to remove dead tissue, treat underlying infection, and reconstruct the area using healthy tissue to restore form and function. Dr. (Maj)(Prof) Ravi Saroha, a senior plastic and reconstructive surgeon in Delhi, offers advanced surgical solutions for Stage 3 and Stage 4 bed sores.
1. Surgical DebridementThe first step in treatment is thorough debridement, which involves surgically removing:
This prepares the wound bed for effective reconstruction and reduces the risk of systemic infection
2. Flap Surgery (Tissue Reconstruction)Once the wound is clean, flap surgery is used to cover the ulcer. A flap involves moving healthy tissue—often skin, fat, and sometimes muscle—from a nearby area to close the wound. Unlike skin grafts, flaps have their own blood supply, making them ideal for deep or high-pressure areas. Types of flaps used include:
These flaps not only fill the defect but also add cushioning to protect against future sores.
Surgery is recommended when a bed sore becomes deep (Stage 3 or 4), does not respond to conservative treatment, becomes chronically infected, or exposes bone, tendon, or muscle. Surgical intervention helps to close the wound and prevent life-threatening complications.
The most common surgical procedure is flap surgery, where healthy tissue (with its own blood supply) is used to cover the wound. In some cases, skin grafting or multiple stage debridements may be done first to prepare the area.
Initial healing takes around 2–3 weeks, but full recovery may take 6–8 weeks, especially in patients with mobility issues or chronic conditions. Bed rest, wound care, and pressure offloading are crucial during this time.
Yes, if the root causes (pressure, immobility, poor nutrition) are not addressed, a bed sore may recur. Preventive care, regular repositioning, and proper cushioning are essential to reduce the chances of recurrence.
There may be some scarring depending on the location and size of the flap or graft. However, flap surgeries are planned to maximize function and minimize visible deformity, and cosmetic revision is possible later if needed.
