Background
Pressure sore, bed sores, and decubitus ulcer have the same meaning and are
used to describe ischemic tissue loss resulting from prolonged pressure over bony
prominence. They can develop anywhere in the body, but often are located in the
trochanteric, ischial, heel, and sacral areas. Although tissue destruction can occur
over areas like the scalp, shoulders, calves, and heels when a patient is lying down,
ischial sores occur in wheelchair-bound patients who are sitting, making ‘pressure
sore’ the better term.
Objectives
The purpose of the study is to describe our experience in the management of sacral
pressure sore with a gluteus maximus myocutaneous flap, its feasibility and
outcome.
Patients and methods
Our prospective study has been conducted in the Surgery Department of Benha
University Hospital from February 2017 to February 2019 on 20 patients treated
with a unilateral gluteus maximus myocutaneous flap to reconstruct the presacral
defect due to pressure sore and all patients have signed informed consents before
they have been involved in this study.
Results
Gluteus maximus flap in presacral pressure sores is a highly feasible and effective
method for the treatment of presacral pressure ulcer defect. It has been associated
with short operative time (average 45 min) and small amounts of intraoperative
blood loss (average 338 ml), three cases out of 20 showed postoperative
hematoma, two cases developed wound dehiscence, two cases developed
infection, one case developed partial flap necrosis, four cases developed
pigmentation, two cases developed keloid, and only one case developed
postoperative recurrence.
Conclusion
The gluteus maximus myocutaneous flap is a useful, safe, and versatile flap for the
repair of presacral decubitus ulcer by a simple approach. It may be recommended
as the procedure of choice for surgical treatment of this type of wound. |
