INTRODUCTION: The impact of adequate follow-up care on patient outcomes cannot be overemphasized. Unfortunately, there is limited information available in regards to the adequate length of post-operative follow-up necessary to monitor pressure sore patients in order to identify early signs of recurrence and prevent progression of the disease. Purpose: To determine the impact of sustained follow-up care on long-term clinical outcomes in patients with pressure sores. METHODS: A retrospective chart review was performed in order to obtain data on all patients that received an operation for a pressure sore in the Department of Plastic Surgery between January 1990 and January 2000. The average time to recurrence was found for the entire group. The patients were divided into groups based on whether they were followed for less than six months post-operatively or longer than six months post-operatively. The incidence of recurrent pressure sores, the stage of recurrent pressure sores, complications and the need for further surgery was compared between the two study groups. RESULTS: A total of 241 patients were included in the study. The average time to pressure sore recurrence was 7.2 ± 0.4 months. The average length of follow-up was 1.4 ± 0.6 years. In the study cohort, 92 patients were followed for less than six months post-operatively and 149 patients were followed for longer than six months post-operatively. The pressure sore recurrence rate for Stage I and II pressure sores was 14% in patients that were followed for less than six months post-operatively and 26% in patients that were followed for longer than six months post-operatively. The pressure sore recurrence rate for Stage III and IV pressure sores was 53% in patients that were followed for less than six months post-operatively and 24% in patients that were followed for longer than six months post-operatively (p < 0.001). The pressure sore recurrence rate for Stage I and II pressure sores was 17% in patients that were followed for less than six months post-operatively and 26% in patients that were followed for longer than six months post-operatively. The need for further surgery was 44% of patients that were followed for less than six months post-operatively and 18% in patients that were followed for longer than six months post-operatively (p < 0.001). Serious post-operative complications including osteomyelitis, femoral head necrosis and Marjolin’s ulcers were all increased in patients that were followed for less than six months post-operatively. CONCLUSION: In pressure sore patients, decreased access to adequate continuity of care has a significant negative impact on long-term patient outcomes. In light of this, pressure sore patients should have long-term coordinated follow-up care for a minimum of six months in order to prevent significant post-operative morbidity including further progression of the disease process, an increase in the incidence of pressure sore recurrence and the need for further operations.