|
KMID : 0358820090360030714
|
|
Journal of Korean Society of Plastic and Reconstructive Surgeons
2009 Volume.36 No. 3 p.714 ~ p.719
|
|
|
Reconstruction of the Recurrent Ischial Sore with Modified Gluteus Maximus Myocutaneous V-Y Advancement flap
|
|
Kim Da-Arm
Oh Sang-Ha
|
|
|
Abstract
|
|
|
Purpose: Recurrent ischial pressure sore is troublesome for adequate soft tissue coverage, because usually its pocket has a very large deep space and adjacent donor tissue has been scarred in the previous surgery. However, the conventional reconstructive methods are very difficult to overcome them. Modified gluteus maximus myocutaneous V-Y advancement flap from buttock can be successfully used in these circumstances.
Methods: From February 2007 to October 2008, modified gluteus maximus myocutaneous V-Y advancement flaps were perfomed in 10 paraplegic patients with recurrent ischial pressure sore. The myocutaneous flap based on the inferior gluteal artery was designed in V-shaped pattern toward the superolateral aspect of buttock and was elevated from adjacent tissue. Furthermore, when additional muscular bulk was required to obliterate dead space, the flap dissection was extended to the inferolateral aspect which can included the adequate amount of the gluteal muscle. After the advanced flap was located in sore pocket, donor defect was repaired primarily. Received February 6, 2009 Revised March 19, 2009 Accepted May 20, 2009 Address Correspondence: Sang Ha Oh, M.D., Department of Plastic and Reconstructive Surgery, Chungnam National University, 33 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea. Tel: 042)280-7387/Fax: 042)280-7384/E-mail: djplastic@ cnu.ac.kr * 본 논문은 2007년 제 63차 대한성형외과학회 학술대회에서 발표되었음. * 이 논문은 2008년도 충남대학교 학술연구비의 지원에 의하여 연구되었음.
Results: The patients’ mean age was 46.9 and the average follow-up period was 12.4 months. The immediate postoperative course was uneventful. But, two patients were treated through readvancement of previous flap due to wound dehiscence or recurrence after 6 months. The long-term results were satisfied in proper soft tissue bulk and low recurrence rate.
Conclusions: The modified gluteus maximus myocutaneous V-Y advancement flap may be a reliable method in reconstruction of recurrent ischial pressure sore, which were surrounded by scarred tissue because of its repetitive surgeries and were required to provide sufficient volume of soft tissue to fill the large pocket.
|
|
|
KEYWORD
|
|
|
Recurrent ischial pressure sore, Gluteus maximus myocutaneous flap, V-Y advancement flap
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|