Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지

Reconstruction of the Recurrent Ischial Sore with Modified Gluteus Maximus Myocutaneous V-Y Advancement flap

변형된 대둔근 V-Y 전진 피판을 이용한 재발성 좌골부 욕창의 재건

  • Lee, SeungRyul (Department of Plastic & Reconstructive Surgery College of Medicine, Chungnam National University) ;
  • Kim, Da-Arm (Department of Plastic & Reconstructive Surgery College of Medicine, Chungnam National University) ;
  • Oh, SangHa (Department of Plastic & Reconstructive Surgery College of Medicine, Chungnam National University)
  • 이승렬 (충남대학교 의과대학 성형외과학교실) ;
  • 김다앎 (충남대학교 의과대학 성형외과학교실) ;
  • 오상하 (충남대학교 의과대학 성형외과학교실)
  • Published : 2009.11.15
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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 have 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. 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.

Keywords

Acknowledgement

Supported by : 충남대학교병원

References

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