Three-dimensional Gluteus Maximus Flap In Recurrent Deep Ischial Pressure Injuries After Previous Fasciocutaneous Flap Reconstruction | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 27 June 2022 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2022.141675.1188 | ||
| Authors | ||
| mostafa Abdelhalim1; Mohammed ELFAHAR2; Reda younis* 3 | ||
| 1Plastic and Reconstructive surgery department, Mansoura university | ||
| 2Plastic & Reconstructive Surgery Department, Mansoura University, Egypt | ||
| 3PLASTIC SURGERY DEPARTMENT, FACULTY OF MEDICINE, MANSOURA UNIVERSITY | ||
| Abstract | ||
| Introduction: Pressure injuries present a substantial burden on hospitals and healthcare facilities. The presence of multiple flaps and techniques for reconstruction of ischial pressure injuries is associated with high recurrence rates, denoting that there is no ideal flap, especially in large and deep cases. The primary cause for recurrence is that the fasciocutaneous flaps that are used for reconstruction target a two-dimensional skin defect and neglect the deep 3rd dimension. Patients and methods: This retrospective study was conducted on thirty patients who suffered 38 recurrent deep ischial pressure injuries (Grade IV) and managed with a combined gluteus maximus mobilization with a simple fasciocutaneous rotation/advancement flap between July 2019 and July 2021. Postoperative complications were recorded. Results The average defect size after debridement ranged between 7.53 ±2.1 SD cm in height and 6.61± 2.2 SD cm in width. While, the mean operative time ranged around 73.94±17.6 SD min. The mean hospital stay was 8.24 ±1.5 SD days. One patient had early superficial wound dehiscence at the tip of the rotation flap and was managed conservatively. Conclusion The three-dimensional gluteus maximus flap is a backup option for the management of recurrent ischial pressure injuries with a simple fasciocutaneous rotation/advancement flap to obliterate the dead space in recurrent cases. This option with a compliant education program can provide a simple and durable solution for serious ischial pressure injuries with low complications and recurrence rates. | ||
| Keywords | ||
| Ischial pressure injury; gluteus maximus muscle; rotation flap; three dimensions | ||
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