Pressure sores are a serious medical and surgical problem, despite growing knowledge on pathophysiology, diagnosis, prevention and treatment. Pressure ulcer occur in several groups of patients, including elderly patients, patients with central nervous system disease and paralysis, chronically ill patients, debilitated patients, patients with long operation ( in hypothermia) and bedridden patients. Efficient management of pressure sores is based on a multidisciplinary team approach, a 'common language' for diagnosis and documentation, and an integrated treatment concept. Prevention remains the cornerstone of management of pressure sores. Treatment of pressure sores includes systemic and local factors. The conservative treatment is the basis of local wound care. Operative treatment can be understood as adjunct to a no more efficient conservative treatment. Using plastic surgical techniques and principles, even large defects can be successfully reconstructed. Simple wound closure nowadays is not sufficient, the defect must stay closed after resuming normal life activities. This requirement especially applies for the young patient age group. The postoperative care is as important as the operation itself to guarantee complete wound healing and prevent recurrence.