Humans ; Adolescent ; Fractures, Avulsion ; Fractures, Bone ; Fracture Fixation, Internal ; Ischium/surgery*

Abnormalities, Multiple ; diagnosis ; surgery ; Anus, Imperforate ; surgery ; Colon ; abnormalities ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Ischium ; abnormalities ; Treatment Outcome ; Twins, Conjoined ; surgery

OBJECTIVETo explore the clinical effect of transplantation of the long head of biceps femoris muscle flap in combination with semi-V posterior thigh fasciocutaneous flap for repair of pressure sores over ischial tuberosity.

METHODSEight patients with 10 deep pressure sores over ischial tuberosity were admitted to the First Affiliated Hospital to the PLA General Hospital and the 98th Hospital of PLA from April 2004 to June 2010. The wounds measured from 2 cm × 2 cm to 6 cm × 4 cm were covered with the long head of biceps femoris muscle flap and semi-V posterior thigh fasciocutaneous flap (ranged from 10 cm × 6 cm to 13 cm × 8 cm). The condition of flaps was observed and followed up for a long time.

RESULTSAll flaps survived. Nine wounds healed by first intention. Subcutaneous accumulation of fluids occurred in one wound with formation of a sinus at drainage site, and it healed after dressing change for 25 days. Patients were followed up for 7 to 34 months. Sore recurred in one patient 9 months after surgery, and it was successfully repaired with the same flap for the second time. Flaps in the other 7 patients appeared satisfactory with soft texture and without ulceration.

CONCLUSIONSThis combined flap is easy in formation and transfer, and it causes little side injury with good resistance against pressure. It is a new method for repair of pressure sore over sacral region.

Adult ; Female ; Humans ; Ischium ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Pressure Ulcer ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps

OBJECTIVETo report our therapeutic effect of double adipofascial turnover flaps in repairing stage IV ischial pressure scores.

METHODSDuring the period of May 2009 to February 2013, we treated 11 cases of stage IV ischial pressure scores with double adipofascial turnover flaps and proper drainage. Based on the conditions of pressure scores and abundant blood supply of adipofascial flaps, we designed two adipofascial flaps on each side of lesion. The two flaps were overlaped to cover the pressure score, following with negative pressure drainage.

RESULTSAll pressure scores healed primarily. The follow-up period ranged from 11 to 36 months with satisfactory results and no recurrence.

CONCLUSIONSDouble adipofascial turnover flaps and proper drainage is a safe and simple method for the treatment of stage IV ischial pressure scores with satisfactory results.

Adipose Tissue ; transplantation ; Drainage ; methods ; Fascia ; transplantation ; Female ; Follow-Up Studies ; Humans ; Ischium ; Male ; Negative-Pressure Wound Therapy ; Pressure ; Pressure Ulcer ; pathology ; surgery ; Recurrence ; Surgical Flaps ; blood supply ; transplantation ; Wound Healing