OBJECTIVE: To test the hypothesis that enhanced education and structured follow-up after pressure ulcer surgery will result in fewer recurrences. DESIGN: Randomized controlled trial. SETTING: Veterans Affairs medical center. PARTICIPANTS: Forty-nine veteran men with spinal cord injury or dysfunction were approached on admission for pressure ulcer surgery. Five never had surgery, 2 refused to participate, and one withdrew. Forty-one were randomized into 3 groups. Three participants' ulcers did not heal, so follow-up could not begin. INTERVENTIONS: Group 1 received individualized pressure ulcer education and monthly structured telephone follow-up (n = 20); group 2 received monthly mail or telephone follow-up without educational content (n = 11); and group 3 received quarterly mail or telephone follow-up without educational content (n = 10). Follow-up continued until recurrence, death, or 24 months. MAIN OUTCOME MEASURE: Time to pressure ulcer recurrence. RESULTS: Group 1 had a longer average time to ulcer recurrence or end of study than groups 2 and 3 (19.6 mo, 10.1 mo, 10.3 mo; p = 0.002) and had a smaller rate of recurrence (33%, 60%, 90%; p = 0.007). Survival analysis confirmed these findings (p = 0.009). CONCLUSIONS: Individualized education and structured monthly contacts may be effective in reducing the frequency of or delaying pressure ulcer recurrence after surgical repair of an ulcer.

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