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KMID : 1144920180140020085
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Journal of Wound Management and Research
2018 Volume.14 No. 2 p.85 ~ p.90
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Reconstruction of Ischial Pressure Sores with Adjacent Muscle Primary Closure and Freestyle Perforator-Based Fasciocutaneous Flaps
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Kim Jae-Hee
Yang Ho-Jik
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Abstract
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Background: The ischial area is particularly vulnerable to pressure sores, and it is susceptible to recurrent sores even after successful treatment. There are various alternatives to treat ischial pressure sores. In this study, we used adjacent muscle primary closure and freestyle perforator-based fasciocutaneous flap operation with padding of the ischium and obliteration of dead space, considering additional surgery due to recurrence of the surgical site.
Methods: We retrospectively analyzed 10 patients who underwent reconstruction using adjacent muscle primary closure and freestyle perforator-based fasciocutaneous flap to treat ischial pressure sores between March 2014 and February 2017. All operations were performed in two stages. The patients’ characteristics, surgical procedure, and clinical course were compared.
Results: The mean age of the patients was 51.7 years (range: 31?68 years), and the mean length of follow-up was 13.3 months (range: 4?20 months). Three patients underwent adjacent muscle primary closure and a posterior thigh fasciocutaneous flap. The rest underwent reconstructive surgery using adjacent muscle primary closure with V-Y advancement fasciocutaneous flap. No recurrences or complications occurred in any of the patients during the follow-up period.
Conclusion: Reconstructive surgery using adjacent muscle primary closure and freestyle perforator-based fasciocutaneous flap is effective for bone padding and dead space obliteration in the treatment of ischial pressure sores. They can also conserve tissue structures and vascularity to allow any additional operations necessitated by recurrent sores.
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KEYWORD
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Pressure sore, Ischium, Muscle, Perforator flap
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