The long-term management of sacral, ischial and trochanteric pressure sores by Myocutaneous Island flaps and their postoperative course

Abstract

Thirty-three patients, mostly paraplegics, were treated for chronic pressure sores Campbell stages IV–VI overlying the sacrum, the ischial tuberosity and the femoral tuberosity. A stable, multi-layered cover of the defect, following excision of the decubiti, could be achieved in one stage using single myocutaneous gluteus maximus and biceps femoris island flaps or, when indicated, a combination of both. The postoperative complication rate was 7/65 (65 myocutaneous flaps were used in 33 patients) or 10.8%. Except for one recurrence due to a traumatic hematoma causing subtotal, external compression of the axial vascular pedicle and consequent partial necrosis of the myocutaneous island flap, all other flaps provided adequate closure and padding. They provided durable cover over a mean follow-up period of 25 months. These results are compared with the relevant literature.