A dual padding method for ischial pressure sore reconstruction with an inferior gluteal artery perforator fasciocutaneous flap and a split inferior gluteus maximus muscle flap
| Autor: | Gordon K. Lee, Inhoe Ku, Eui Cheol Jeong, Saehoon Yoon |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Bursitis Pressure sores lcsh:Surgery 030230 surgery Pressure ulcer 03 medical and health sciences 0302 clinical medicine Ischium medicine.artery Inferior gluteal artery medicine Surgical Flaps Gluteus maximus muscle flap business.industry Osteomyelitis lcsh:RD1-811 medicine.disease Surgery body regions Fasciocutaneous flap Surgical flaps 030220 oncology & carcinogenesis Original Article business |
| Zdroj: | Archives of Plastic Surgery Archives of Plastic Surgery, Vol 46, Iss 5, Pp 455-461 (2019) |
| ISSN: | 2234-6171 2234-6163 |
| DOI: | 10.5999/aps.2019.00031 |
| Popis: | Background Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based fasciocutaneous flap and a muscle flap is expected to resolve the disadvantages of previously introduced surgical methods. Methods Fifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) fasciocutaneous flap and a split inferior gluteus maximus muscle flap from January 2011 to June 2016, were analyzed retrospectively. The split muscle flap was rotated to obliterate the deep ischial defect, managing the osteomyelitis or bursitis, and the IGAP fasciocutaneous flap was rotated or advanced to cover the superficial layer. The patients’ age, sex, presence of bursitis or osteomyelitis, surgical details, complications, follow-up period, and ischial sore recurrence were reviewed. Results All ischial pressure ulcers were successfully reconstructed without any flap loss. The mean duration of follow-up was 12.9 months (range, 3–35 months). Of 15 patients, one had a recurrent ulcer 10 months postoperatively, which was repaired by re-advancing the previously elevated fasciocutaneous flap. Conclusions The dual-flap procedure with an IGAP fasciocutaneous flap and split inferior gluteus maximus muscle flap for ischial pressure ulcer reconstruction is a useful method that combines the useful characteristics of perforator and muscle flaps, providing thick dual padding with sufficient vascularization while minimizing donor morbidity and vascular pedicle injury. |
| Databáze: | OpenAIRE |
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