Pressure ulcers are classified from Stage 1, which involves non-blanching redness of intact skin, through Stage 2 involving partial skin thickness loss, Stage 3 involving full thickness skin and fat loss, and Stage 4 involving full thickness tissue loss with exposed bone, tendon, or muscle. Surgery is generally recommended from Stage 3 onward when conservative wound management has failed, when deep infection or necrotic tissue is present, when the wound involves exposed deep structures, or when the wound cavity is too large to fill without tissue transfer. At Galwa Care Hospital, the surgical plan is individualised based on the wound stage and the patient's overall fitness.

Surgical management typically begins with thorough debridement to remove all dead, necrotic, and infected tissue and define the true extent of the wound cavity. Negative pressure wound therapy is then commonly used to promote healing tissue growth and prepare the wound for definitive closure. For deep or large pressure ulcers, flap reconstruction is the most reliable treatment, where a section of well-vascularised muscle or skin and fat from a nearby area is rotated or advanced to fill the cavity and provide durable, well-padded coverage over the bony prominence. Skin grafting may also be used in selected cases for shallower wounds.

Yes, pressure ulcers are largely preventable with the right care strategies in place. Regular repositioning of bedridden or wheelchair-bound patients, use of pressure-relieving mattresses and cushions, meticulous skin care to prevent moisture damage, optimisation of nutrition, and prompt treatment of any early skin changes are all essential preventive measures. After surgical treatment of a pressure ulcer, the same measures must be implemented rigorously alongside any changes to the patient's seating or positioning situation to prevent the wound from recurring. At Galwa Care Hospital, prevention planning is an integral part of the care programme for every bed sore patient.

Recovery timelines vary significantly depending on the stage of the ulcer, the extent of the reconstruction required, the patient's overall medical health, and how effectively pressure relief and nutrition are managed during healing. Flap reconstructions for deep Stage 4 ulcers typically require a period of careful immobilisation to protect the flap while it heals, followed by a gradual and supervised return to sitting or mobility. Smaller wounds managed conservatively may heal over several weeks, while complex surgical reconstructions in medically compromised patients can require many months of structured follow-up care before durable healing is confirmed.