Under general anesthesia, the inside of the pressure sore was stained with methylene blue and then excised completely in a pseudotumor fashion. The superficial 1cm of the sacrum was removed with an osteotome. Bilateral V to Y flaps were then outlined, dissected and advanced to close the wound. Two large suction drains were placed.
Fig. 2. Pressure sore after debridement and outline of bilateral V to Y advancement flaps.
Fig. 3. Flaps have been dissected and are ready to be advanced to close the wound.
Fig. 4. The flaps have been sutured in place.