Ischial pressure sores: Reconstruction using the perforator‐based reverse flow musculocutaneous 180° propeller flap
- 15 June 2009
- journal article
- case report
- Published by Wiley in Microsurgery
- Vol. 29 (8), 672-675
- https://doi.org/10.1002/micr.20678
Abstract
The treatment of pressure sores requires soft tissue reconstruction with thick tissue to provide padding of bony prominences and obliterate dead space. Fasciocutaneous flaps may not provide adequate bulk. Propeller flaps (180°) based on perforators from the gluteal artery may be harvested as a reverse flow musculocutaneous flap including a muscle plug to reconstruct deep cavities. Three patients presenting with deep pressure sores required reconstruction of large cavities. In addition to a regular 180° propeller flap, a muscle plug based on a perforator found in the blade of the propeller was used to add bulk to the flap and obliterate the cavity with well‐vascularized tissue. One flap required secondary closure of the donor site due to dehiscence, one hematoma required drainage. All flaps survived completely. No recurrence of osteomyelitis or pressure sores was seen. The 180° propeller flap can be harvested as a reverse flow musculocutaneous flap including a muscle plug in the distal blade. This adds volume which is required to adequately obliterate large cavities in cases of osteomyelitis. This new technique may be useful in other areas as well. © 2009 Wiley‐Liss, Inc. Microsurgery 2009.Keywords
This publication has 8 references indexed in Scilit:
- Die Defektdeckung des distalen Unterschenkeldrittels mit perforatorbasierten 180°-PropellerlappenZentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie, 2008
- MOC-PSSM CME Article: Pressure SoresPlastic and Reconstructive Surgery, 2008
- Nonlinear Finite Element Simulations to Elucidate the Determinants of Perforator Patency in Propeller FlapsAnnals of Plastic Surgery, 2007
- The 180-Degree Perforator-Based Propeller Flap for Soft Tissue Coverage of the Distal, Lower ExtremityAnnals of Plastic Surgery, 2007
- Muscle versus Nonmuscle Flaps in the Reconstruction of Chronic Osteomyelitis DefectsPlastic and Reconstructive Surgery, 2006
- Gluteal Perforator Flaps for Coverage of Pressure Sores at Various LocationsPlastic and Reconstructive Surgery, 2006
- The Propeller Flap Version of the Adductor Muscle Perforator Flap for Coverage of Ischial or Trochanteric Pressure SoresAnnals of Plastic Surgery, 2006
- Distally Based Sural Fasciomusculocutaneous Flap for Chronic Calcaneal Osteomyelitis in Diabetic PatientsAnnals of Plastic Surgery, 2005