Clover-Style Fasciocutaneous Perforator Flap for Reconstruction of Massive Sacral Pressure Sores.
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TL;DR: The clover-style fasciocutaneous perforator flap is ideal for the reconstruction of massive sacral pressure sores because it is a relatively simple procedure and results in good appearance and function, few complications, and a low recurrence rate.
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Abstract: BACKGROUND As a common complication of the long-term bedridden patients, pressure sore is a great challenge for surgeons. The purpose of this study was to explore the surgical method of using a clover-style fasciocutaneous perforator flap raised on the buttocks for the treatment of massive sacral pressure sores and report the clinical outcomes. METHODS The study included 15 patients from January 2015 to June 2017 with an average age of 52.87 years (range, 32-73 years). The size of the sacral pressure sores ranged from 10 cm × 13 cm to 18 cm × 20 cm. The defects were reconstructed using a fasciocutaneous perforator flap raised on the buttocks after debridement and vacuum sealing drainage treatment for 1 to 2 weeks. All the donor areas were sutured directly. RESULTS All flaps survived completely; 13 patients achieved healing by primary intention, and the other 2 patients achieved healing by secondary intention. At the mean follow-up period of 20.8 months (range, 12-46 months), the appearance of the flap, including its texture and color, in all patients was satisfactory. No patients had deep infection, necrosis, or shrinkage of the flap during the follow-up period. One patient had a recurrent bedsore during the 2-year follow-up. CONCLUSIONS The clover-style fasciocutaneous perforator flap is ideal for the reconstruction of massive sacral pressure sores because it is a relatively simple procedure and results in good appearance and function, few complications, and a low recurrence rate.
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Citations
A Guide to Perforator Flap Selection for Buttock Pressure Sore Reconstruction
Jian-yuan Zhou,Xiaojin Mo,S. Xiao,Shusen Chang,Wei Chen,Zairong Wei +5 more
TL;DR: The authors' approach can support surgeons in selecting the appropriate flaps to repair stage IV buttock pressure ulcers and achieve excellent reconstructive outcomes and is worthy of promotion.
References
Pressure sores: classification and management.
TL;DR: Management of soft tissue breakdown overlying bony prominences is correlated with the extent of the lesion and ranges from local wound care, turning and systemic support for Grade I and II, to local and radical excision with soft tissue flap closure for the more extensive Grades III and IV.
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The gluteal perforator-based flap for repair of sacral pressure sores
TL;DR: A gluteal perforator-based flap employing the gluteus maximus muscle perforators located around the sacrum is described, which requires no transection or sacrifice of the glutesal region, and elevation time for the flap is short.
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The superior and inferior gluteal artery perforator flaps
TL;DR: The reliable size and consistency of the superior and inferior gluteal artery perforators allow the use of pedicled and free superior and superior gluteAL artery per forator flaps in a variety of clinical situations.
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Anatomical and radiological study of the superior and inferior gluteal arteries in the gluteus maximus muscle for musculocutaneous flap in Koreans
TL;DR: The position, distribution pattern, and perforating branch of the superior gluteal artery and the inferior glutesal artery in the gluteus maximus muscle (GMM) were investigated through fine dissection and the radiological method.
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Pedicled Fasciocutaneous Flap of Multi-island Design for Large Sacral Defects
TL;DR: A new pedicled fasciocutaneous flap for large sacral defects that combined a classic superior gluteal artery perforator flap and an acentric axis perforators pedicling propeller flap is designed and considered a good alternative for reconstructing large sacrals defects.