The gluteus maximus V-Y advancement flap for reconstruction of extensive soft tissue loss following an advanced sacral pressure ulcer. A case report and mini review

Tchuenkam, Landry W.; Titcheu, Flobert; Mbonda, Aimé Noula; Kamto, Trevor; Nwaha, Axel M.; Kamla, Igor; Tochie, Joël Noutakdie

doi:10.1016/j.ijscr.2020.06.060

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…The “3 muscle flaps” using the thigh musculature and total thigh flap with lower-leg amputation have been described. [ 18 , 19 ] Pedicle transverse rectus abdominis myocutaneous flap, [ 15 ] gluteus maximus V-Y flap, [ 20 ] and Dufourmentel LLL flap had also been reported. Most straightforwardly, after limb sacrifice, a pedicle or free fillet flap can be used in hip disarticulation, hemipelviectomy, or even hemicorporectomy.…”

Section: Discussionmentioning

confidence: 99%

Marjolin’s ulcer in an ischial pressure sore presented with necrotizing soft tissue infection: A case report

et al. 2023

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Rationale: Marjolin’s ulcer (MU) is a rare skin malignancy derived from a chronic wound. Pressure ulcer related MU possesses poor prognosis and high metastatic rate, and it is difficult to be differentiated, especially when superimposed infection. Patient concerns: Here we report a case with pressure ulcer related MU which presented as necrotizing soft tissue infection (NSTI) to demonstrate the manifestation, treatment, and prognosis of this rare disease. Diagnoses: A 45-year-old male patient had spinal cord injury at age 2 years. He presented ischial pressure sore complicated with NSTI initially. After serial debridements and antibiotic treatment, the infection subsided. For the persistent verruca-like skin lesion, he underwent wide excision which revealed well-differentiated squamous cell carcinoma. Further image studies showed localized residual tumor without distant metastasis. Interventions: He then underwent hip disarticulation and anterior thigh fillet flap reconstruction. Local recurrence developed 3 months later, and re-wide excision and inguinal lymph node dissection were performed. No lymph node metastasis was noted and adjuvant radiotherapy was given. Outcomes: He was followed for 34 months and no recurrence or metastasis was found. The patient can move with a wheelchair or a hip prosthesis, and is partially dependent for daily activities. Lessons: MU can masquerade as NSTI and one should be alert to its malignant potential. Due to its aggressive nature, limb sacrifice can be considered in circumstances of profound involvement. As for the reconstruction method, pedicled fillet flap provided good wound coverage.

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Section: Discussionmentioning

confidence: 99%

Marjolin’s ulcer in an ischial pressure sore presented with necrotizing soft tissue infection: A case report

et al. 2023

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“…Finally, obesity especially at the level of the folds is responsible for a maceration that maintains the infection. Once there is an infection at the surgical site, its management meets the general principles of all wound infection management : wound debridement, cleansing, dressing and coverage (reconstruction) [ 15 ]. The optimization of the treatment of SSI also involves the management of risk factors which in our case is mainly maceration.…”

Section: Discussionmentioning

confidence: 99%

Panniculectomy as a surgical option for the management of a deep surgical site infection after C-section in a morbidly obese woman: a case report

Kamla¹,

Bwelle

Tochie

et al. 2023

Patient Saf Surg

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Background Obesity is an independent risk factor for the occurrence of surgical site infections (SSIs) following all types of surgeries, especially after Caesarean section (C-section). SSIs increase postoperative morbidity, health economic cost and their management is quiet complex with no universal therapeutic consensus. Herein, we report a challenging case of a deep SSI after C-section in a central morbidly obese woman managed successfully by panniculectomy. Case presentation A 30-year-old black African pregnant woman with marked abdominal panniculus extending to the pubic area, a waist circumference = 162 cm and BMI = 47.7 kg/m2 underwent an emergency CS indicated for acute fetal distress. By day five post-operation, she developed a deep parietal incisional infection unremitting to antibiotic therapy, wound dressings and beside wound debridement till the 26th postoperative day. A large abdomen panniculus and maceration of the wound enhanced by central obesity increased the risk of failure of spontaneous closure; thus, an abdominoplasty by panniculectomy was indicated. The patient underwent panniculectomy on the 26th day after the initial surgery and her post-operative course was uneventful. Wound esthetics was satisfactory three months later. Adjuvant dietary and psychological management were associated. Conclusion Post-Caesarean deep SSI is a frequent complication in obese patients. A panniculectomy may be a safe and promising therapeutic surgical option with good cosmetic results and little postoperative complications when used in a multidisciplinary anti-obesogenic approach.

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Combined application of gluteus maximus muscle flaps and random pattern skin flaps in repairing sacrococcygeal sinus tracts: a prospective study and technical note

Bian,

Qiu,

et al. 2024

Updates Surg

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The gluteus maximus V-Y advancement flap for reconstruction of extensive soft tissue loss following an advanced sacral pressure ulcer. A case report and mini review

Cited by 6 publications

References 8 publications

Marjolin’s ulcer in an ischial pressure sore presented with necrotizing soft tissue infection: A case report

Marjolin’s ulcer in an ischial pressure sore presented with necrotizing soft tissue infection: A case report

Panniculectomy as a surgical option for the management of a deep surgical site infection after C-section in a morbidly obese woman: a case report

Combined application of gluteus maximus muscle flaps and random pattern skin flaps in repairing sacrococcygeal sinus tracts: a prospective study and technical note

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