Repair of ischial tuberosity pressure ulcer with a perigluteal muscle flap

Abstract

Background: Pressure ulcers are caused by long-term pressure on tissues. Hip pressure ulcers are the most common type. Pressure ulcers in the buttocks are classified into three types: sacrococcygeal, ischial tuberosity, and femoral tuberosity. Methods: We used perigluteal muscle tissue flaps to treat nine cases of grade IV pressure ulcers from January 2016 to August 2018. A retrospective study was conducted on all patients who had an ischial tuberosity pressure ulcer repaired with a perigluteal muscle flap. The gluteus maximus myocutaneous flap was combined with the gluteal fasciocutaneous flap, the biceps femoris myocutaneous flap was combined with the gluteal fasciocutaneous flap, the gracilis myocutaneous flap, the biceps femoris myocutaneous flap, and the semitendinosus and semimembranosus myocutaneous flap. Wounds of different sizes and depths were encountered, the details of which are discussed in treatment methods. Data from patients, including age, gender, cause of injury, wound dimensions, the timing of flap coverage, and complications, were analyzed. Results: The appearance of the skin flap was complete after muscular tissue flap repair, with no visible scar hyperplasia. However, after six to 12 months of follow-up, the flap was soft and left a small linear scar. Conclusions: In the repair of an ischial tuberosity pressure ulcer, a peri gluteal muscle flap provides both aesthetic and functional results. Before using muscle tissue flap transplantation, it is recommended to perform multiple debridement + VSD to improve the wound foundation.