Results: Recurrent pressure sores in plegic patients are common complications requiring long-standing conservative or operative therapy. Additional risk factors such as diabetes increase the complication rate for surgery. Surgery itself may be di cult in recurrent pressure sores due to limited remaining soft tissues. We report the case and treatment of a 47-year-old patient with long-standing and recurrent ulcers and complications after¯ap surgery. As a ®nal option we added plasma transglutaminase (factor XIII) to our treatment scheme which changed the course of the disease dramatically and we achieved complete and rapid healing. Conclusion: Our experience suggests that F XIII has a positive role in treating pressure sores as shown already in several other surgical ®elds. Its use is giving the surgeon an additional tool in complicated cases.

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