Treatment of Ischial Pressure Sores by Means of Sclerotherapy Using Absolute Ethanol

Abstract

In Brief The ischial region is a common site of pressure sore. The ischial pressure sore with a large subcutaneous bursa is resistant to conservative treatment and tends to require radical surgical treatment. In this article the authors describe their experience with a simple surgical treatment on 8 ischial pressure sores in 7 patients with subcutaneous bursa by means of sclerotherapy using absolute ethanol. This method involves causing the bursa to become scarred and closing it up by sterilizing, fixing, and denaturing by the pharmacologic effect of absolute ethanol instead of surgical excision of the bursa. This alternative method has a possibility of treating pressure sores as well as other fistulous diseases in various areas. Eight recurrent ischial pressure ulcers in 7 patients were surgically treated by trimming the cutaneous edges, saline irrigation, placement of a suction drain, tightly suturing the skin edges, and 6 successive 90-second instillations of absolute alcohol via the drain, followed by postoperative suction drainage. Six patients remain healed after mean 9.5-month follow-up, and a seventh healed after an identical reoperation.