Volume : 08, Issue : 12, December – 2021

Title:

17.RESULTS OF SACRAL PRESSURE SORES SURGICAL CLOSURE BY GLUTEAL SKIN FLAP

Authors :

Dr. Hammal khan, Dr Muhammad Anwar, Dr Muhammad Bilal, Dr Gul Muhammad, Dr Arif mehmood

Abstract :

Aim: Pressure ulcers are a long-term medical problem; it was even found during the autopsy of Egyptian mummies. This prospective study was conducted to evaluate the surgical outcome of sacral pressure ulcer closure with gluteal skin flaps.
Place and Duration: In the Plastic Surgery department of Bolan Medical Complex Hospital, Quetta
for six months duration from April 2021 to September 2021.
Methods: The study included 22 patients with stage III and IV pressure ulcers. More than two-thirds (68.2%) of the ulcers were stage III, and more than three-quarters (77.3%) had local signs of infection. While the mean horizontal and vertical length of the cavities before excision were 10.4 and 8.8 cm, respectively, after excision of the dead and dead tissue it increased to 12.6 and 10.6 cm, respectively. The mean medial lobe shift was 6.3 cm.
Results: Postoperative observation of the flap revealed no infection, seroma, or hematoma in any of the patients. Only 2 (9.1%) patients had marginal flap loss. In two cases, marginal flap defects were excised and a direct suture was applied (secondary closure). Over 90% of the patients had good results.
Conclusions: The study found that the gluteal flap gives a good result in the majority of patients with large cruciate wounds, with almost no complications and recurrences. The gluteal flap has advantages such as preserving the musculature, less morbidity at the site of collection, versatility in design, and less extraction effort.
Key words: pressure ulcers, gluteal flap, cross dressing.

Cite This Article:

Please cite this article in press Hammal khan et al, Results Of Sacral Pressure Sores Surgical Closure By Gluteal Skin Flap., Indo Am. J. P. Sci, 2021; 08(12).

Number of Downloads : 10

References:

1. Chen CY, Chiang IH, Ou KL, Chiu YL, Liu HH, Chang CK, Wu CJ, Chu TS, Hsu KF, Huang DW, Tzeng YS. surgical treatment and strategy in patients with pressure sores: A single-surgeon experience. Medicine. 2020 Oct 30;99(44).
2. Tchuenkam LW, Titcheu F, Mbonda A, Kamto T, Nwaha AM, Kamla IJ, Tochie JN. The gluteus maximus VY advancement flap for reconstruction of extensive soft tissue loss following an advanced sacral pressure ulcer. A case report and mini review. International Journal of Surgery Case Reports. 2020 Jan 1;73:15-21.
3. Cheng J, Zhang Q, Feng S, Wu X, Huo W, Ma Y, Cai J, Liu M. Clover-Style Fasciocutaneous Perforator Flap for Reconstruction of Massive Sacral Pressure Sores. Annals of Plastic Surgery. 2021 Jan;86(1):62.
4. Arikrishnan D, Balakrishnan TM, Janardhanam J. Pedicled Chimeric Perforator Flap Based on Inferior Gluteal Vessel Axis for the Reconstruction of Stage-Four Primary Ischial Pressure Sores—A New Design. Indian Journal of Plastic Surgery. 2021 Apr;54(02):177-85.
5. Gopalakrishnan R, Rajalingam M, Rajagunasekaran B, Esakimuthu R. Reconstruction of pressure ulcers with flaps in a tertiary care centre. International Surgery Journal. 2021 Jan 29;8(2):647-53.
6. Boro S, Kalita D, Kiling D, Mathew AK. Reconstruction of a sacral defect with bilateral gluteus maximus VY advancement flap following resection of squamous cell carcinoma (Marjolin’s ulcer). Annals of Oncology Research and Therapy. 2021 Jan 1;1(1):64.
7. Nassar MK, Jordan DJ, Quaba O. The internal pudendal artery turnover (IPAT) flap: A new, simple and reliable technique for perineal reconstruction. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2021 Sep 1;74(9):2104-9.
8. Arowojolu OA, Wirth GA. Sacral and Ischial Pressure Ulcer Management With Negative-Pressure Wound Therapy With Instillation and Dwell. Plastic and Reconstructive Surgery. 2021 Jan 1;147(1S-1):61S-7S.
9. Sinnott CJ, Stavrides S, Boutros C, Kuruvilla A, Glickman LT. Dual-Plane Gluteal Myocutaneous Flap for Reconstruction of Ischial Tuberosity Pressure Wounds. Annals of Plastic Surgery. 2020 Jul 1;85(S1):S23-7.
10. Shambhu SK. Involvement in the utilization of sugar glue dressing followed by recreation of sacral weight sore with VY fold: A solid answer for a significant issue.
11. Abdelmofeed AM, Abdelhalim MF. Feasibility of gluteus maximus myocutaneous pedicled flap for presacral pressure sore reconstruction: a simple approach. The Egyptian Journal of Surgery. 2020 Jul 1;39(3):613.
12. Estawrow MA, Farag SA. Versatility of Gluteal Arteries Perforator Flaps (for Local Coverage) Relative to Defect Size, Site, and Different Pathological Conditions. The Egyptian Journal of Plastic and Reconstructive Surgery. 2020 Oct 1;44(4):513-8.
13. Hsu KF, Chen CY, Wang CH, Dai NT, Chen SG, Chen TM, Tzeng YS. Extensive Sacral Pressure Sore Reconstructed with Staged Negative Pressure Wound Therapy Dermatotraction and Superior Gluteal Artery Perforator Flap Reconstruction–A Case Report. 臺灣整形外科醫學會雜誌. 2021 Mar 1;30(1):39-47.
14. Ellabban MA, Wyckman A, Abdelrahman I, Steinvall I, Elmasry M. Dual Reconstruction of Lumbar and Gluteal Defects with Freestyle Propeller Flap and Muscle Flap. Plastic and Reconstructive Surgery Global Open. 2021 Jan;9(1).
15. Gascoigne AC, Flood S. Pressure Injuries. InPlastic Surgery-Principles and Practice 2022 Jan 1 (pp. 642-650). Elsevier.
16. Padilla PL, Hancock EL, Ruff ES, Zapata-Sirvent RL, Phillips LG. Pressure Injuries. InTips and Tricks in Plastic Surgery 2022 (pp. 367-376). Springer, Cham.
17. Tsukuura R, Yamamoto T. Sensate superior gluteal artery perforator flap for reconstruction of sacrococcygeal large wound dehiscence: A case report and literature review. Microsurgery. 2021 Nov 9.
18. Wei Z, Zhu J, Lin T, Cai H, Fang X, Zhu Y, Yang X, Cheng J. Application of damage control surgery in patients with sacrococcygeal deep decubitus ulcers complicated by sepsis. Journal of International Medical Research. 2021 Oct;49(10):03000605211049876.
19. Alfeehan MJ, Aljodah MA, Al-Zajrawee MZ, Marzook AA. Random pattern hatchet flap as a reconstructive tool in the treatment of pressure sores: clinical experience with 36 patients. The Annals of The Royal College of Surgeons of England. 2021 May;103(5):374-9.
20. Pignatti M, D’Arpa S, Roche N, Giorgini FA, Lusetti IL, Lorca‐Garcia C, De Santis G, Berenguer B. Surgical treatment of pressure injuries in children: A multicentre experience. Wound Repair and Regeneration. 2021 Nov;29(6):961-72.