Abdel Halim, M., El Fahar, M., Younis, R. (2022). Three-Dimensional Gluteus Maximus Flap in Recurrent Deep Ischial Pressure Injuries after Previous Fasciocutaneous Flap Reconstruction. The Egyptian Journal of Plastic and Reconstructive Surgery, 46(3), 307-312. doi: 10.21608/ejprs.2022.254760
Mostafa Abdel Halim; Mohamed El Fahar; Reda A. Younis. "Three-Dimensional Gluteus Maximus Flap in Recurrent Deep Ischial Pressure Injuries after Previous Fasciocutaneous Flap Reconstruction". The Egyptian Journal of Plastic and Reconstructive Surgery, 46, 3, 2022, 307-312. doi: 10.21608/ejprs.2022.254760
Abdel Halim, M., El Fahar, M., Younis, R. (2022). 'Three-Dimensional Gluteus Maximus Flap in Recurrent Deep Ischial Pressure Injuries after Previous Fasciocutaneous Flap Reconstruction', The Egyptian Journal of Plastic and Reconstructive Surgery, 46(3), pp. 307-312. doi: 10.21608/ejprs.2022.254760
Abdel Halim, M., El Fahar, M., Younis, R. Three-Dimensional Gluteus Maximus Flap in Recurrent Deep Ischial Pressure Injuries after Previous Fasciocutaneous Flap Reconstruction. The Egyptian Journal of Plastic and Reconstructive Surgery, 2022; 46(3): 307-312. doi: 10.21608/ejprs.2022.254760
Three-Dimensional Gluteus Maximus Flap in Recurrent Deep Ischial Pressure Injuries after Previous Fasciocutaneous Flap Reconstruction
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.
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