Archives of Plastic Surgery

  • 제41권4호
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  • Pages.387-393
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  • 2014
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

  • Kim, Chae Min (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine) ;
  • Yun, In Sik (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Dong Won (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine) ;
  • Lew, Dae Hyun (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine) ;
  • Rah, Dong Kyun (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Won Jai (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine)
  • 투고 : 2014.04.29
  • 심사 : 2014.05.30
  • 발행 : 2014.07.15
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초록

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.

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참고문헌

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피인용 문헌

  1. Sensate anterolateral thigh perforator flap for ischiatic sores reconstruction in meningomyelocele patients vol.35, pp.4, 2014, https://doi.org/10.1002/micr.22330
  2. Comparison of Posteromedial Thigh Profunda Artery Perforator Flap and Anterolateral Thigh Perforator Flap for Head and Neck Reconstruction vol.137, pp.1, 2014, https://doi.org/10.1097/prs.0000000000001880
  3. The versatility of profunda femoral artery perforator flap for oncological reconstruction after cancer resection—Clinical cases and review of literature vol.114, pp.2, 2014, https://doi.org/10.1002/jso.24294
  4. SURGICAL RECONSTRUCTION IN PRESSURE ULCERS- A RETROSPECTIVE STUDY OF THE WORKHORSE FLAP OPTIONS vol.3, pp.92, 2016, https://doi.org/10.18410/jebmh/2016/1054
  5. The use of a combined profunda femoris perforator-based fasciocutaneous flap and gracilis muscle flap in the treatment of ischial pressure wounds in patients with limited mobility vol.42, pp.4, 2014, https://doi.org/10.1007/s00238-019-01523-z
  6. Wound Management of Multi-Site Pressure Ulcer at Different Stages in Elderly Patients vol.14, pp.None, 2014, https://doi.org/10.2147/ccid.s316694
  7. A Systematic Review Comparing Outcomes of Local Flap Options for Reconstruction of Pressure Sores vol.88, pp.1, 2014, https://doi.org/10.1097/sap.0000000000002941