Management of wounds in anesthetic tissue.

The management of trophic ulcers, the most common wound in hypesthetic or anesthetic tissue, is reviewed. Pressure from an extrinsic source is the most important factor leading to development of the lesion, but the threshold for ulceration is markedly lowered by impairment of protective vasomotor reflexes and metabolic responses. Prevention of severe or sustained compression of such tissue is the hallmark of proper management. The most useful surgical procedures are also discussed.