Island Gluteal Thigh Flap for Coverage of Ischial Bed Sores

Document Type : Original Article

Authors

The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Tanta Uuniversity

Abstract

Background: Many flaps have been described for reconstruction
of ischial pressure sores; each of them has its merits
and drawbacks. Gluteal thigh flap have been reported for
coverage of ischial defects. Several variations of the gluteal
thigh flap have been used, including a transposition flap, an
advancement flap and an island flap. This study aimed at
evaluation of the reliability of the island gluteal thigh flap in
primary ischial pressure sores reconstruction.
Patients and Methods: A prospective study was performed
on 13 patients (10 males and 3 females), admitted to the Dep.
of Plastic Surgery between June 2016 and June 2019, suffering
from ischial pressure ulcers. Of them, eight were grade III
and five were grade IV who underwent island gluteal thigh
flap for coverage. The mean age of patients was 31.3 years.
The mean ulcer size was 4.9x7.1cm. 13 island gluteal thigh
flaps were used.The mean flap dimensions were 8.1cm in
length and 5.9cm in width. The donor sites were closed
primarily in all patients.
Results: 13 island gluteal thigh flaps were used.The mean
flap dimensions were 8.1cm in length and 5.9cm in width.
The donor sites were closed primarily in all patients. Twelve
flaps survived completely. There was no complete flap loss
in our study. However, we had an overall rate of complications
about 23%; venous congestion in 2 cases, partial superficial
flap necrosis in 1 case and hematoma in 1 case. After an
average follow-up period of 12 months, one ulcer (7.7%)
recurred.
Conclusion: Island gluteal thigh flap is reliable in primary
ischial pressure sores reconstruction provided that the primary
source vessel is included. This flap is highly efficient and easy
to raise. It spares adjacent cutaneous territories for recurrent
cases and preserves gluteus maximus muscle for patients who
will be ambulant with minimal donor site morbidity.

Keywords

Main Subjects

References

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