Use of Inferior Gluteal Artery and Posterior Thigh Perforators in Management of Ischial Pressure Sores With Limited Donor Sites for Flap Coverage

Unal, Cigdem; Ozdemir, Jale; Yirmibesoglu, Oktay Ahmet; Yücel, Ergin; Ağır, Hakan

doi:10.1097/sap.0b013e31821ee432

Cited by 14 publications

(7 citation statements)

References 18 publications

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“…Among these, the IGAPs distributed in the gluteal region have been frequently used in reconstructive surgery for ischial pressure sores after Higgins et al [7] reported a case in which the IGAP was successfully used [18,19]. …”

Section: Discussionmentioning

confidence: 99%

“…The perforators that can be used for ischial pressure sore defects are largely divided into those in the gluteal regions and those in the thigh regions. Unal et al [ 18 ] divided the origins of the perforators into two groups depending on the available donor flap site: 1) IGA and perforators of the descending branch of the IGA, and 2) posterior thigh vessels (medial or lateral circumflex femoral artery, profunda femoris artery).…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

et al. 2014

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BackgroundReconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores.MethodsWe retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course.ResultsAll flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months.ConclusionsThe combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

et al. 2014

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“…The concept of PAP flap including skin paddle in posteromedial thigh had been described as either a posterior thigh flap or an adductor magnus perforator flap in the literature and transferred in different fashions, such as advancement flap , transposition flap , island pedicle flap, and free flap . The posterior thigh region is loosely defined as a region bordered by the inferior gluteal fold superiorly, the iliotibial tract laterally, the thigh adductors medially, and the popliteal fossa inferiorly.…”

Section: Discussionmentioning

confidence: 99%

“…This option can be modified using the propeller concept for flap transposition as introduced by Hallock reported in two patients. Lee et al , Hurwitz et al , and Unal et al for the same reason have used V‐Y adductor magnus perforator advancement flaps, with limited morbidity, but avoided a donor‐site skin graft. To date, many articles have been published in reconstruction of ischial or trochanteric pressure sores with fasciocutaneous or myocutaneous flap including gracilis or adductor magnus muscle.…”

Section: Discussionmentioning

confidence: 99%

The versatility of profunda femoral artery perforator flap for oncological reconstruction after cancer resection—Clinical cases and review of literature

Ito

Huang

et al. 2016

Journal of Surgical Oncology

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“…Unal et al treated 11 patients with ischial sores using the inferior gluteal artery or posterior thigh vessels (lateral or medial circumflex femoral artery or DFA). Nine IGAP flaps were used, two of them being advancement flaps and seven being transposition flaps.…”

Section: Discussionmentioning

confidence: 99%

Posterior thigh perforator flaps: An anatomical study to localize and classify posterior thigh perforators

et al. 2013

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In the last decade perforator flaps have been used increasingly for different indications. Many regions may serve as donor site. In this respect the posterior thigh region (PTR) has been neglected as a potential donor site for many years. The purpose of this study was to provide complete mapping of perforators supplying the posterior thigh region. Twelve fresh cadaver thighs were prepared injecting diluted acrylic paint into the iliac artery. Thereafter the posterior thighs were dissected from medial to lateral, distinguishing the perforators at the level of the superficial fascia. The perforators were localized and origin, source, length and diameter of the perforators were documented. Analysis occurred using ANOVA and the two proportion Z test. The distribution of musculocutaneous and septocutaneous perforators was respectively 69.1% and 30.9% (P = 0.002). The PTR was divided in thirds. Most perforators (53.2%) were found in de middle third of the PTR. The deep femoral artery (DFA) was the main origin of perforators (61.7%), followed by the superficial femoral artery (SFA) (27.7%) and the popliteal artery (PA) (10.6%). The DFA perforators were the longest with a mean length of 13.7 ± 4,69 cm, the SFA perforators were 9.79 ± 3.76 cm and the PA perforators were 8.6 ± 3.37 cm. The PTR offers a sufficient number of suitable perforators to serve as an adequate donorsite for pedicled and free flaps.

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Use of Inferior Gluteal Artery and Posterior Thigh Perforators in Management of Ischial Pressure Sores With Limited Donor Sites for Flap Coverage

Cited by 14 publications

References 18 publications

Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

The versatility of profunda femoral artery perforator flap for oncological reconstruction after cancer resection—Clinical cases and review of literature

Posterior thigh perforator flaps: An anatomical study to localize and classify posterior thigh perforators

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