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

Authors :
Chae Min Kim
In Sik Yun
Dong Won Lee
Dae Hyun Lew
Dong Kyun Rah
Won Jai Lee
Source :
Archives of Plastic Surgery, Vol 41, Iss 04, Pp 387-393 (2014)
Publication Year :
2014
Publisher :
Thieme Medical Publishers, Inc., 2014.

Abstract

Background Reconstruction 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. Methods We 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. Results All 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. Conclusions The 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.

Details

Language :
English
ISSN :
22346163 and 22346171
Volume :
41
Issue :
04
Database :
Directory of Open Access Journals
Journal :
Archives of Plastic Surgery
Publication Type :
Academic Journal
Accession number :
edsdoj.2d5a4bb85e0a42a9842dc5b169695b05
Document Type :
article
Full Text :
https://doi.org/10.5999/aps.2014.41.4.387