TY - JOUR T1 - Management of the giant sacral decubitus ulcer JF - Trauma Surgery & Acute Care Open JO - Trauma Surg Acute Care Open DO - 10.1136/tsaco-2022-001019 VL - 7 IS - 1 SP - e001019 AU - Uswa A Iqbal AU - Aurelie Tran AU - Mary R Shen AU - Gary A Vercruysse Y1 - 2022/12/01 UR - http://tsaco.bmj.com/content/7/1/e001019.abstract N2 - We accepted a transfer of a paraplegic female with spina bifida aged 34 years who presented to an outside hospital with left-sided sacropelvic and femoral osteomyelitis resulting from very large pressure ulcers (figure 1). Following initial debridement of the ulcers, she became acutely ill. Plastic surgery, orthopedics, and acute care surgery all recommended a palliative care consult. Her parents came to us for a second opinion. On arrival, we found the patient to be septic, obtunded, malnourished, and in renal failure. For acute management, she was intubated, resuscitated, and initiated on broad-spectrum antibiotics. She was then taken to the operating room (OR) where her wound was thoroughly explored and debrided, and antibiotics were tailored to her cultures. She responded well to initial management, regained renal function, and was successfully weaned off the ventilator. As she was lucid, she was included in a conversation about possible wound management options.Figure 1 Extent of the decubitus ulcer is shown. Posterior pelvis and femur are exposed in the base of the wound. The small contralateral decubitus ulcer was treated successfully with local wound care.Palliative … ER -