Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps.
10.5999/aps.2014.41.4.387
- Author:
Chae Min KIM
1
;
In Sik YUN
;
Dong Won LEE
;
Dae Hyun LEW
;
Dong Kyun RAH
;
Won Jai LEE
Author Information
1. Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. pswjlee@yuhs.ac
- Publication Type:Original Article
- Keywords:
Pressure ulcer;
Ischium;
Perforator flap;
Muscle
- MeSH:
Arteries*;
Estrogens, Conjugated (USP);
Follow-Up Studies;
Humans;
Ischium;
Perforator Flap*;
Pliability;
Pressure Ulcer*;
Recurrence;
Retrospective Studies;
Surgical Procedures, Operative;
Wounds and Injuries
- From:Archives of Plastic Surgery
2014;41(4):387-393
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. METHODS: We retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. RESULTS: All flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months. CONCLUSIONS: The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.
