Modified lumbar artery perforator flaps for gluteal pressure sore reconstruction. Issue 12 (21st March 2016)

• Record Type: Journal Article
• Authors: Yoon, Chi Sun; Yim, Ji Hong; Kim, Min Ho; Ha, Won; Kim, Kyu Nam
• Is Part Of: ANZ journal of surgery. Volume 87:Issue 12(2017)
• Page Start: 1035
• Page End: 1039
• Publication Date: 2016-03-21
• Subjects: gluteal region -- perforator flap -- pressure ulcer -- reconstructive surgical procedure -- surgical flaps; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.13494
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract : Background: Gluteal perforator flaps (GPFs) are the most useful for gluteal region pressure sore reconstruction. However, application is difficult if the surrounding area has scar tissue from previous operations or trauma, especially with recurrent sores. We describe the use of modified lumbar artery perforator flaps when GPFs cannot be used. Methods: Between May 2009 and April 2014, 51 patients underwent gluteal pressure sore reconstructions with gluteal ( n = 39) or modified lumbar artery ( n = 12) perforator flaps. Patients in the modified lumbar artery perforator group had scar tissue from trauma or previous surgery. In this retrospective review, we analyzed patient age and sex, defect size and location, operative time, follow‐up duration, immediate postoperative issues, flap necrosis, dehiscence, re‐operation, donor‐site morbidity and recurrence. Complications and clinical outcomes were compared between groups. Results: We found no significant differences in patient demographics, surgical complications or clinical outcomes. There were eight cases of temporary congestion (20.51%) and four of partial flap necrosis (10.25%) in the gluteal perforator group. In the modified lumbar artery perforator group, there were three cases of temporary congestion (25%) and one of partial flap necrosis (8.33%). No pressure sores recurred during follow‐up in either group. Conclusion: GPFs are the gold standards for gluteal pressure sores, but modified lumbar artery perforator flaps are relatively easy and useful when GPFs cannot be used due to scar tissue.