A One-Size-Fits-All Approach to Pressure Ulcers: Whole-Buttock Fasciocutaneous Advancement Flap. (17th April 2023)

• Record Type: Journal Article
• Authors: Chen, Jill; Chen, Jian-An; Chen, Chien-Chung; Yang, Yi-Hsuan; Teklu, Yonas Eshetu; Chang, Li-Ren; Feng, Kuan-Ming
• Is Part Of: Annals of plastic surgery. Volume 90(2023)Supplement 1
• Page Start: S95
• Page End: S102
• Publication Date: 2023-04-17
• Subjects: pressure injury -- fasciocutaneous -- recurrent ulcer -- sacral ulcer -- incisional negative pressure therapy; Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/SAP.0000000000003466
• Languages: English
• ISSNs: 0148-7043

Abstract

Abstract : Background: Buttock pressure injuries can be difficult to treat. There are many choices of flaps to reconstruct these wounds, but few are large, technically simple, and easily recycled. Aim and Objective: We are presenting our experience on surgical reconstruction of buttock pressure injuries using large whole-buttock fasciocutaneous flaps that are easily designed for ulcers regardless of location and size and are easily recycled for treatment of recurrences. Material and Methods: We conducted a retrospective review of all patients who received reconstruction with fasciocutaneous rotational flaps for buttock region pressure injuries from January 2013 to December 2018. The key steps of this one-size-fits-all flap include elevation of a large, oversized flap to achieve tension-free closure, avoiding fascial incisions over bony prominences, placing the V-Y type closure wound in the posteromedial thigh, and the use of closed incisional negative wound therapy postoperatively. Results: Fifty patients underwent 54 flaps reconstruction for coverage of stage 4 gluteal pressure injuries between January 2013 and December 2018. Seventy-four percent healed without the need for further operation. The average size of the defect was 90 cm 2 (maximum = 300 cm 2 ). The average follow-up period was 31 months. Four of the 54 flaps were "recycled" flaps, 3 were performed for the coverage of recurrent ulcers and 1 flap was performed for treatment of a postoperative wound dehiscence. Conclusions: We recommend this simple, one-size-fits-all approach, whole-buttock fasciocutaneous flap when surgically treating gluteal pressure injuries for selected patients.