Whether treated with surgery or by conservative, nonsurgical measures, pressure ulcers recur in 5% to 91% of spinal cord injured (SCI) patients. Factors other than the surgical technique used or the standard conservative management provided may be responsible. A retrospective study of 176 SCI patients with a history of one or more pressure ulcers was conducted at the Department of Veterans Affairs Medical Center at Castle Point, N.Y. Approximately 35% of patients who received either surgical or nonsurgical treatment had a recurrence. Patients who smoked and patients with diabetes or cardiovascular disease had higher recurrence rates.