MOC-PSSM CME Article: Pressure Sores

In Brief Learning Objectives: After studying this article, the participant should be able to: 1. Understand and describe the physiology of pressure sore development. 2. Understand and describe population risk factors. 3. Understand and describe examination and classification. 4. Understand and describe common surgical treatment algorithms. 5. Understand and describe strategies for prevention and postoperative recurrence. Summary: Pressure sores are ischemic damage to soft tissues resulting from unrelieved pressure, usually over a bony prominence. In both acute and chronic circumstances, a careful, structured multidisciplinary strategy is required from initial diagnosis to resolution. Mechanical issues, such as the relief of pressure, adequate surgical debridement, and flap coverage, are of little value if educational, nutritional, social, and resource-based issues are not in place. The authors discuss a range of topics, including etiology, physiology, classification, operative options, and strategies to prevent recurrence. The Maintenance of Certification module series is designed to help the clinician structure his or her study in specific areas appropriate to his or her clinical practice. This article is prepared to accompany practice-based assessment of preoperative assessment, anesthesia, surgical treatment plan, perioperative management, and outcomes. In this format, the clinician is invited to compare his or her methods of patient assessment and treatment, outcomes, and complications with authoritative, information-based references. This information base is then used for self-assessment and benchmarking in parts II and IV of the Maintenance of Certification process of the American Board of Plastic Surgery. This article is not intended to be an exhaustive treatise on the subject. Rather, it is designed to serve as a reference point for further in-depth study by review of the reference articles presented. MOCERT AVAILABLE AT http://www1.plasticsurgery.org/ebusiness4/OnlineCourse/CourseInfo.aspx?Id=14002.