We read with great expectations the article from Foster et al1 in the August issue of the ARCHIVES, in which the authors develop a rationale for flap selection. We hoped to find answers to questions raised when we read their similar article2 1 month ago, which used the same results and conclusions while focusing only on ischial pressure sore coverage. Unfortunately, we again found simply a ranking of flaps according to their primary healing rate. While we congratulate the authors on their convincingly high 89% success rate, we would like to see an explanation of why the flap recommended as the first choice should be superior to the second-choice flap, and why the same flap is superior when applied to one location but should be avoided in the next.
Wechselberger G, Schoeller T, Otto A. Principles in the Operative Treatment of Pressure Sores. Arch Surg. 1998;133(4):465. doi: