Application of gluteus maximus fasciocutaneous V-Y advancement flap combined with resection in sacrococcygeal pressure ulcers

Abstract

Background:Traditional gluteus maximus myocutaneous flaps have generally been used to fill tissue defects after resection of sacrococcygeal pressure ulcers. However, postoperative complications were gradually revealed as increasing operations were performed. This study aimed to introduce the innovative application of gluteus maximus fasciocutaneous V-Y advancement flaps for repairing tissue defects and to comparatively analyze the differences between the innovative and traditional flaps.Methods:A total of 32 cases were included in this study. All the PU lesions were removed by resection. Sixteen cases used the gluteus maximus myocutaneous flaps, and the remaining 16 cases used gluteus maximus fasciocutaneous V-Y advancement flaps to fill the tissue defects after surgery. Comparative analysis between the gluteus maximus myocutaneous flaps and gluteus maximus fasciocutaneous V-Y advancement flaps was used to evaluate the 2 flaps based on the mean operating time, postoperative infection, paresthesia, appearance of flaps, and recurrence.Results:The gluteus maximus fasciocutaneous V-Y advancement flaps required a reduced operating time and a more simple operation compared with the gluteus maximus myocutaneous flaps. Although the infectious risk of the gluteus maximus fasciocutaneous V-Y advancement flaps was reduced compared with the gluteus maximus myocutaneous flaps, the gluteus maximus myocutaneous flaps have a better appearance compared with the gluteus maximus fasciocutaneous V-Y advancement flaps. Most importantly, no flap necrosis was noted, and the recurrence rate during follow-up was reduced in cases using the gluteus maximus fasciocutaneous V-Y advancement flaps.Conclusion:The combined application of gluteus maximus fasciocutaneous V-Y advancement flaps with surgical resection can reduce the postoperative complications and aid in the treatment of sacrococcygeal pressure ulcers.

Simple and Efficient Pressure Ulcer Reconstruction via Primary Closure Combined with Closed-Incision Negative Pressure Wound Therapy (CiNPWT)—Experience of a Single Surgeon

“…For a single flap, the reported maximum reconstruction area for SGAP flaps can reach 12 × 14 cm [2], whereas it can reach 12 × 12 cm for bilateral gluteus maximus myocutaneous V-Y advancement flaps [1]. However, operation times for flap reconstruction surgery are lengthy [2,33,36], and require general anesthesia. Moreover, for the most common pressure ulcers occurring in the sacral region, flap reconstruction surgery should be performed in the prone position with intubation.…”

The application of keystone flap combined with vacuum‐assisted closure in the repair of sacrococcygeal skin defect after tumor resection

“…Furthermore, tumors that develop in this area are another cause for skin defects, which take a long time to heal because of the anatomic characteristic of the area and the large size of the defect. Gluteus maximus myocutaneousflaps have historically been used for the treatment of tissue defects in the sacrococcygeal region, but they have the disadvantages of long operative times and high risk of infection …”

“…Gluteus maximus myocutaneousflaps have historically been used for the treatment of tissue defects in the sacrococcygeal region, but they have the disadvantages of long operative times and high risk of infection. 5,6 For small tumors, the skin defect can be directly sutured after resection. However, a skin graft is required to close an extremely large wound and undue tension exists.…”

Factores de riesgo para complicaciones de cirugías reconstructivas de ulceras de decúbito pélvicas: experiencia de 10 años

“…colgajo miocutáneo de los isquiotibiales, colgajo miocutáneo de bíceps crural, colgajo miocutáneo de tensor de la fascia lata, colgajo miocutáneo Gracilis, mioplastia de glúteo mayor inferior y colgajo de piel posterior del muslo a pedículo interno. En nuestro caso utilizamos como técnica de cierre para la úlcera isquiática, el colgajo glúteo mayor a pedículo inferior en isla cutánea o en forma de V-Y ya que en general no presenta complicaciones y permite el re avance del colgajo en caso de recidiva [5][6][7][8][9] .…”