Comparison of Hatchet-Shaped Tensor Fascia Lata Flap and Pedicle Anterior Lateral Thigh Flap for Treatment of Trochanteric Sores

Li, Chun-Chang; Chang, Stephen S.; Fu, Ju-Peng; Tzeng, Yuan‐Sheng; Wang, Chih-Hsing; Chen, Tim‐Mo; Chen, Shyi-Gen

doi:10.1097/sap.0b013e3182586fac

Cited by 12 publications

(11 citation statements)

References 18 publications

(12 reference statements)

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Section: Discussionmentioning

confidence: 97%

“…According to Wang et al and our previous studies, the modified design of the pALT myocutaneous flap without skeletonisation of perforators is reliable and easily harvested for the reconstruction of trochanteric and ischium pressure sores with limited morbidity. 13,15,16 Li et al 17 reported that pALT flaps have a lower recurrence rate but require a longer FIGURE 2 An 83-year-old woman with multiple pressure sores. A, B, C, 12 cm × 16 cm sacral pressure sore, 8 cm × 5 cm right trochanteric pressure sore, and 3 cm × 3 cm left trochanteric pressure sore, respectively; D, left trochanteric pressure sores treated with delayed primary closure; E, right trochanteric defect covered with hatchet-shaped tensor fascia lata flap; F, planning of SGAP flap for sacrum defect; G, appearance of elevated f lap; and H, I, postoperative result 8 weeks after the surgery operative time and prolonged anaesthesia than hatchetshaped TFL flaps for the surgical management of trochanteric sores.…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment and strategy in patients with multiple pressure sores

Chiang

Wang

Tzeng

2018

International Wound Journal

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Pressure sores remain a common health problem, particularly among the physically limited or bedridden elderly, and can cause significant morbidity and mortality. This study aimed to present our surgical treatment and strategy for patients with multiple pressure sores. Between January 2010 and December 2016, 18 patients were enrolled. After adequate debridement, pressure sores were managed based on our treatment protocol. Patients' age, aetiology, defect size and location, flap reconstruction, outcome, and follow-up period were reviewed. A total of 10 men and 8 women (average age, 82.3 years) with a mean follow-up period of 28.3 months (6-72 months) were included. The mean defect area was 63.7 cm . The most common aetiology of the bedridden state was cerebrovascular accident (38.89%), and the most frequent sores were trochanteric pressure sores (53.57%). The average operative time and blood loss were 105.5 minutes and 100.8 mL, respectively. No haemodynamic variation or blood transfusion was noted during the surgery. The complication rate for each sore was 10.7%, including late recurrence. In conclusion, treating pressure ulcers requires careful patient education, intensive multidisciplinary optimisation, and meticulous wound care, and our treatment protocol ensures a shorter surgery time, less bleeding, and low complication rate.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Surgical treatment and strategy in patients with multiple pressure sores

Chiang

Wang

Tzeng

2018

International Wound Journal

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“…The TFL flap can be designed with a hatchet-shaped incision to provide more well-vascularized muscle to fill the wound defect, or combined with tangential splitting of the vastus lateralis to increase flap distance (13)(14)(15). Another commonly used flap for trochanteric reconstruction is the pedicled ALT flap, which has lower rates of ulcer recurrence compared to the hatchet-shaped TFL flap (16).…”

Section: Reconstructive Considerationsmentioning

confidence: 99%

Trochanteric pressure ulcers: preoperative management and reconstructive considerations

et al. 2019

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“…44 ►Table 4 describes other LE functional measures described by four studies, including limitation of motion, joint stiffness, function recovery, and mean time to return to baseline function. 7,32,44,47 Only two studies described the weight-bearing status of patients separately from ambulatory status (►Table 3). 14, 54 Yang et al reported full weight-bearing status in all 15 patients, while Lu et al described time to weight-bearing; in their diabetic foot ulcer patient population, the time to initial weight bearing was an average of 2 AE 1.3 months, and time to full weight bearing was an average of 3 AE 1.5 months after FTT.…”

Section: Functional Outcomesmentioning

confidence: 99%

The Need to Improve Patient-Centered Outcome Reporting Following Lower Extremity Flap Reconstruction: A Systematic Review and Meta-analysis

Kim

Tirrell

Dekker

et al. 2021

J Reconstr Microsurg

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Introduction Research in lower extremity (LE) wound management involving flap reconstruction has primarily focused on surgeon-driven metrics. There has been a paucity in research that evaluates patient-centered outcomes (PCO). This systematic review and meta-analysis examines articles published between 2012 and 2020 to assess whether reporting of functional and quality of life (QOL) outcomes have increased in frequency and cohesiveness, compared with the previous two decades. Methods PubMed and Ovid were queried with appropriate Medical Subject Heading (MeSH) terms for studies published between June 2012 and July 2020. For inclusion, each study had to report any outcome of any tissue transfer procedure to the LE in comorbid patients, including complication rates, ambulation rates, flap success rates, and/or QOL measures. The PCO reporting prevalence was compared with a previous systematic review by Economides et al which analyzed papers published between 1990 and June 2012, using a Pearson's Chi-squared test. Results The literature search yielded 40 articles for inclusion. The proportion of studies reporting PCO was greater for literature published between 1990 and 2012 compared with literature published between 2012 and 2020 (86.0 vs. 50.0%, p < 0.001). Functional outcomes were more commonly reported between 1990 and 2012 (78.0 vs. 47.5%, p = 0.003); similarly, ambulatory status was reported more often in the previous review (70.0 vs. 40.0%, p = 0.004). This study solely examined the rate at which PCO were reported in the literature; the individual importance and effect on medical outcomes of each PCO was not evaluated. Conclusion Less than 50% of the literature report functional outcomes in comorbid patients undergoing LE flap reconstruction. Surprisingly, PCO reporting has seen a downward trend in the past 8 years relative to the preceding two decades. Standardized inclusion of PCO in research regarding this patient population should be established, especially as health care and governmental priorities shift toward patient-centered care.

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Comparison of Hatchet-Shaped Tensor Fascia Lata Flap and Pedicle Anterior Lateral Thigh Flap for Treatment of Trochanteric Sores

Cited by 12 publications

References 18 publications

Surgical treatment and strategy in patients with multiple pressure sores

Surgical treatment and strategy in patients with multiple pressure sores

Trochanteric pressure ulcers: preoperative management and reconstructive considerations

The Need to Improve Patient-Centered Outcome Reporting Following Lower Extremity Flap Reconstruction: A Systematic Review and Meta-analysis

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