Three-Dimensional Gluteus Maximus Flap in Recurrent Deep Ischial Pressure Injuries after Previous Fasciocutaneous Flap Reconstruction

Document Type : Original Article

Authors

The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Mansoura University

Abstract

Background: Pressure injuries present a substantial burden
on hospitals and healthcare facilities. The presence of multiple
flaps and techniques for reconstruction of ischial pressure
injuries is associated with high recurrence rates denoting that
there is no ideal flap, especially in large and deep cases. The
main cause for recurrence is that the fasciocutaneous flaps
that are used for reconstruction target a two-dimensional skin
defect and neglects the deep 3rd dimension.
Patients and Methods: This retrospective study was
conducted on thirty patients who suffered 38 recurrent deep < br />ischial pressure injuries (Grade IV) and managed with a
combined gluteus maximus mobilization with simple fasciocutaneous
rotation/advancement flap between July 2019 and
July 2021. Post-operative complications were recorded.
Results: The average defect size after debridement ranged
between 7.53±2.1 SD cm in height and 6.61±2.2 SD cm in
width. While the mean operative time ranged around 73.94±
17.6 SD min. The mean hospital stay was 8.24±1.5 SD days.
One patient had early superficial wound dehiscence at the tip < br />of the rotation flap and was managed conservatively.
Conclusion: The three-dimensional gluteus maximus flap < br />is a backup option for the management of recurrent ischial
pressure injuries with a simple fasciocutaneous rotation/
advancement flap to obliterate the dead space in recurrent
cases. This option with a compliant education program can
provide a simple and durable solution for serious ischial
pressure injuries with low complications and recurrence rates.

Keywords

Main Subjects

References

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