Surgical treatment for ischial pressure sores with gracilis myocutaneous flap

Akgüner, Muharrem; Karaca, Cezmi; Atabey, Atay; Menderes, Adnan; Top, Hüsamettin

doi:10.12968/jowc.1998.7.6.276

Cited by 14 publications

(9 citation statements)

References 7 publications

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“…The surgical management of pressure sores involves thorough debridement of the wound, including the infected bursa and any bone that may be involved, followed by flap coverage. The flaps used include the gracilis, 1,2 tensor fasciae latae, 3 biceps femoris, 4 gluteus maximus, 5 gluteal thigh, 6 hamstring, 7 anterolateral thigh, 8 and inferior gluteal artery perforator flaps. 9 The use of each of these has its advantages and disadvantages, and currently, there is no definitive surgical method for the management of pressure sores.…”

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confidence: 99%

Treatment of Ischial Pressure Sores Using a Modified Gracilis Myofasciocutaneous Flap

Lin

Hou²,

Chen³

et al. 2009

J reconstr Microsurg

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Despite the availability of a variety of flap reconstruction options, ischial pressure sores continue to be the most difficult pressure sores to treat. This article describes a successful surgical procedure for the coverage of ischial ulcers using a modified gracilis myofasciocutaneous flap. From August 2000 to April 2004, 12 patients with ischial sores were enrolled in the study. All patients underwent early aggressive surgical debridement followed by surgical reconstruction with a modified gracilis myofasciocutaneous flap. The follow-up period ranged from 13 to 86 months, with a mean of 44 months. Overall, 91.7% of the flaps (11 of 12) survived primarily. Partial flap necrosis occurred in one patient. Primary wound healing occurred without complications at both the donor and recipient sites in all cases. In one patient, grade II ischial pressure sores recurred 13 months after the operation. There was no recurrence in other 11 patients. A modified gracilis myofasciocutaneous flap provides a good cover for ischial pressure sores. Because it is easy to use and has favorable results, it can be used in the primary treatment for large and deep ischial pressure sores.

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confidence: 99%

Treatment of Ischial Pressure Sores Using a Modified Gracilis Myofasciocutaneous Flap

Lin

Hou²,

Chen³

et al. 2009

J reconstr Microsurg

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“…25,26 Gracilis muscle and musculocutaneous flaps can also reach to the perianal and ischial location without diffculty. [27][28][29] The trochanteric region is another important location for pressure sores and tensor fasciae latae, 30 -32 gluteus maximus muscle, and musculocutaneous flaps 33 are the flaps used most often in the trochanteric area. Although muscle and musculocutaneous flaps have proved their success in pressure sore management, the major disadvantage of these flaps is the sacrifice of a muscle and its function; this is especially important in ambulatory patients.…”

Section: Resultsmentioning

confidence: 99%

Gluteal Perforator Flaps for Coverage of Pressure Sores at Various Locations

Coşkunfırat

Özgentaş

2004

Plastic and Reconstructive Surgery

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Flap coverage is essential for successful treatment of pressure sores, and musculocutaneous flaps have been preferred universally. Development of perforator flaps supplied by musculocutaneous perforators has allowed reconstructive surgeons to harvest flaps without including muscles. Perforator flaps have enhanced the possibility of donor sites because a flap can be supplied by any musculocutaneous perforator, and donor-site morbidity is also reduced. Between November of 1998 and June of 2002, the authors used 35 gluteal perforator flaps in 32 consecutive patients for coverage of pressure sores located at sacral (n = 22), ischial (n = 7), and trochanteric (n = 6) regions. The mean age of the patients was 53.1 years (range, 5 to 87 years), and there were 16 male and 16 female patients. All flaps in this series were supplied by musculocutaneous arteries arising from gluteal muscles. Patients were followed up for a mean period of 13.6 months. Wound dehiscence was observed in two patients and treated by secondary closure. Three patients died during the follow-up period. All flaps survived except one that had undergone total necrosis, and only one recurrence was noted during the follow-up period. Gluteal perforator flaps are safe and reliable options for coverage of pressure sores located at different locations. Freedom in flap design and low donor-site morbidity make gluteal perforator flaps an excellent choice for pressure sore coverage.

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“…As conservative management for these ulcers is often ineffective, especially for Grade III or Grade IV ulcers, 12 further readvancement of the myocutaneous flap or other fasciocutaneous flap has been used to close the defect. [2][3][4][5][6][7][8] Despite the wide variety of flap-coverage options, the ischial pressure sore remains the most difficult sore to treat. Paraplegic patients may require several flaps for the closure of ischial pressure sores during their lifetime.…”

Section: Discussionmentioning

confidence: 99%

“…1 Surgical treatment for ischial pressure ulcers presents a significant problem. Although myocutaneous and fasciocutaneous flaps have been used for the closure of ischial sores, [2][3][4][5][6][7][8] the use of these flaps is associated with a high rate of ulcer recurrence. 9 It is generally agreed that the ulcer-recurrence rate associated with the use of fasciocutaneous flaps is lower than that associated with the use of myocutaneous flaps.…”

mentioning

confidence: 99%

Long-term Outcome of Using Posterior-thigh Fasciocutaneous Flaps for the Treatment of Ischial Pressure Sores

Lin¹,

Hou²,

Chen³

et al. 2010

J reconstr Microsurg

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Among the many difficult problems presented by patients with spinal cord injuries, management of ischial pressure ulcers remains challenging for reconstructive surgeons. This study describes the long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores. Between January 1999 and June 2003, 12 patients with ischial sores were enrolled in this study. All the patients underwent early aggressive surgical debridement followed by surgical reconstruction with a laterally based posterior-thigh fasciocutaneous flap. The follow-up period ranged from 24 months to 97 months (mean, 62 months). All the flaps survived, and there were no partial flap losses. Primary-wound healing occurred in all the cases. In two patients, Grade II ischial pressure sores recurred 24 months and 27 months after the operation. There was no recurrence in the other 10 patients. The posterior-thigh fasciocutaneous pedicled flap was a good method for treating ischial bed sores. This flap could be used to treat recurrences observed after primary bed-sore treatment with other methods. The flap was easy to raise, and it did not cause any donor-site morbidity. The long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores was generally good.

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Surgical treatment for ischial pressure sores with gracilis myocutaneous flap

Cited by 14 publications

References 7 publications

Treatment of Ischial Pressure Sores Using a Modified Gracilis Myofasciocutaneous Flap

Treatment of Ischial Pressure Sores Using a Modified Gracilis Myofasciocutaneous Flap

Gluteal Perforator Flaps for Coverage of Pressure Sores at Various Locations

Long-term Outcome of Using Posterior-thigh Fasciocutaneous Flaps for the Treatment of Ischial Pressure Sores

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