MYOCUTANEOUS FLAPS AS SAFE DEFECT COVERIN G OF HIGH-GRADE PELVIC PRESSURE SORES

Citation
K. Warbanow et al., MYOCUTANEOUS FLAPS AS SAFE DEFECT COVERIN G OF HIGH-GRADE PELVIC PRESSURE SORES, Langenbecks Archiv fur Chirurgie, 382(6), 1997, pp. 359-366
Citations number
14
ISSN journal
00238236
Volume
382
Issue
6
Year of publication
1997
Pages
359 - 366
Database
ISI
SICI code
0023-8236(1997)382:6<359:MFASDC>2.0.ZU;2-1
Abstract
Infected pelvic pressure sores of Campbell stages IV-VII require soft tissue reconstruction, which means stable, multi-layered filling cover of the defect and reliable prophylaxis of relapse. Myocutaneous flaps meet these conditions well. Depending on the extent and the area of t he sore, with predilection for the sacrum, the ischial tuberosity and the femoral trochanter. the gluteus maximus. biceps femoris and tensor fasciae latae muscles are most often used for myocutaneous flaps. Pri mary sutures, split skin grafts or local fasciocutaneous flaps are oft en sufficient treatment for smaller, superficial defects. Between 1981 and 1996, 133 patients (average age 50 years) with 212 pelvic pressur e sores of all stages were treated in our clinic. After radical decubi tus excision with pseudotumor technique and resection of the osseous p rominences, one-stage reconstruction of solitary as well as multiple d efects was performed with myocutaneous flaps in 135 cases. The postope rative general complication rate for all treatments was about 10-30%. With regard to the muscle flaps, one third healed without any problems , partial flap necrosis occurred in 6% and there was total loss of fla p in 2% of all myocutaneous flaps. According to present knowledge, myo cutaneous flaps seem to be the most reliable method for definitive cov ering of deep pelvic pressure sores, independent of the cause of the u lcer.