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American Journal of Hospice and Palliative Medicine®
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Surgical Palliative Care of Advanced Wounds

K. Francis Lee, MD, FACS

General surgeon Springfield, Massachusetts, kflee{at}acucern.com

William J. Ennis, DO, MBA, FACOS

Midwestern University, Association for the Advancement of Wound Care, Comprehensive Wound and Disease Management Center, Olympia Fields, Illinois

Geoffrey P. Dunn, MD, FACS

Surgical Palliative Care Task Force, American College of Surgeons, Erie, Pennsylvania

The history of surgery is rich with accomplishments in wound care, a legacy that recently has been abandoned by many surgeons only to be taken up by nonsurgical providers. When dealing with advanced wounds at the end of life, such as pressure ulcers or venous stasis ulcers, goals of treatment are relief of pain, elimination of odor, and control of wound exudates and infection. Benefits and risks of surgical intervention must be discussed with the patient and family in terms of the patient's perceived prognosis, extent of tissue necrosis and infection, the rate of deterioration, and the underlying wound pathogenesis. When appropriate, the role of surgery looms large in the treatment of chronic, advanced wounds, especially when minimally invasive surgical techniques are used.

Key Words: sacral pressure ulcer • palliative surgery • surgical decision-making

American Journal of Hospice and Palliative Medicine®, Vol. 24, No. 2, 154-160 (2007)
DOI: 10.1177/1049909107299915
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