INFRAGLUTEAL FASCIOCUTANEOUS FLAP FOR MANAGEMENT OF RECURRENT ISCHIAL PRESSURE SORE
Keywords:Infragluteal fasciocutaneous flap, ischial pressure sore, perforator plus flap, recurrent pressure ulcer
Aim: The aim of the study was to determine the feasibility of infragluteal fasciocutaneous flap in recurrent ischial pressure sore.
Materials and Methods: This prospective cross-sectional study was carried out in Department of Burn and Plastic Surgery at Government Medical College and Hospital, Bettiah, Bihar, India from Dec 2017 to july 2018. 13 patients suffering from recurrent ischial sore with scars of previous surgery were managed with infragluteal fasciocutaneous flap. Wound bed was prepared by surgical debridement and negative pressure wound therapy in each case. In two cases, gracilis muscle flap was used as adjuvant to fill up the residual cavity. Donor area of flap was primarily closed.
Results: Infragluteal fasciocutaneous flap was used in all nine cases. Superficial distal congestion was present in 3 cases. Haematoma (2) and infection (2) at flap donor site occurred. Recurrence of ulcer was observed in 3 cases which were managed by bursectomy and advancement of the bridge segment of the original infragluteal fasciocutaneous flap. All flaps survived without any major complication.
Conclusion: Infragluteal fasciocutaneous flap is reliable option for managing recurrent ischial sore as it transposes well-vascularised thick fasciocutaneous flap from adjacent posterior thigh and its bridge segment can be further used in case of recurrence.
Keywords: Infragluteal fasciocutaneous flap, ischial pressure sore, perforator plus flap, recurrent pressure ulcer
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