Abstract
<p>Surgical management of ischial pressure sores has always been a challenge due to high recurrence rate. Ischial pressure sores develop due to unrelieved pressure over the Ischium. Inferior gluteus maximus island flap has been used effectively for coverage of ischial pressure sores.</p><p><strong>Objective:</strong><strong> </strong>To describe the efficacy of inferior gluteus maximus flap for reconstruction of ischial pressure sores.</p><p><strong>Methods:</strong><strong> </strong>A retrospective case series, consisted of sample of 17 cases. The study was conducted in the Department of Plastic and Reconstructive Surgery, Post Graduate Medical Institute, Lahore General Hospital Lahore, over a period of 8 years from March 2008 to March 2016. The case series included17 patients with grade 3 and grade 4 ischial pressure sores, comprising 12 male and 5 female, with age range of 28 to 64 (mean = 46 years).Follow-up ranged from 1 to 4 years with a mean of 2.5 years. Inferior gluteus maximus island flap was used for reconstruction of Ischial pressure sores.</p><p><strong>Results: </strong>In thirteen (76%) of the seventeen patients, wound healed uneventfully without any complication. Partial wound dehiscence was observed in 2 patients (12%). Both of these healed with conservative wound management. Recurrence was seen in 2 patients (12%) after 8 months. These two patients underwent <em>reoperation</em> and gluteus maximus flap was readvanced that resulted in satisfactory wound coverage.</p><p><strong>Conclusion:</strong> Inferior gluteus maximus island flap can be considered as a reliable option for reconstruction of ischial pressure sores.</p>
Highlights
Pressures sores tend to develop when excessive pressure, shear and friction is applied to soft tissue for an extensive period of time.[1]Treatment of pressure sores always begin with prevention
Recurrence was seen in 2 patients (12%) after 8 months. These two patients underwent reoperation and gluteus maximus flap was readvanced that resulted in satisfactory wound coverage
Inferior gluteus maximus island flap can be considered as a reliable option for reconstruction of ischial pressure sores
Summary
Pressures sores tend to develop when excessive pressure, shear and friction is applied to soft tissue for an extensive period of time.[1]. Treatment of pressure sores always begin with prevention. Prevention mainly comprises relieving pressure at bony prominences, preventing infection and improving the nutrition of patients. Conservative approach till remains the first line of management for pressure sores but when pressure sores involve the deep structures like muscle or bone, surgical treatment is indicated.[2]. Among the various surgical techniques which have been described for closure of pressure sores, commonly used are local or regional flaps. These flaps are broadly classified either myocutaneous or fasciocutaneous flaps.[3]
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