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Surgical management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Surgical management entails:

  • removal of all slough and necrosis from wound as it hinders the growth of underlying granulation tissue; satisfactory debridement is indicated by fresh capillary bleeding
  • wound should be repeatedly re-examined and further slough removed
  • assessment for the presence of abscess communicating with ulcer base:
    • it should be entered, its walls broken down, and the cavity packed
    • antibiotic cover is required, as is the case if cellulitis is seen around the ulcer margin
  • resistant ulcers may benefit from reconstructive surgery:
    • rotational skin flaps for buttocks
    • split skin grafts for heals
  • dressings; alternatives include:
    • gauze roll replaced regularly
    • silicone foam elastomer, washed and replaced regularly

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