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Pressure ulcers are a significant hazard in the bedridden, spine-injured, and neuromuscular-disease population. Prevention remains the primary goal in the management of this difficult problem. Patient education and compliance coupled with a medical team approach can reduce the occurrence of pressure ulcers significantly. Surgical guidelines include appropriate patient selection, adequate debridement and soft tissue coverage, and use of flaps that will not limit future reconstructions should the pressure ulcer(s) recur. Postoperatively, a strict protocol should be adapted to ensure the success of the flap procedure. Several myocutaneous flaps commonly used for the surgical management of pressure are discussed.