The posterior thigh flap for defect coverage of ischial pressure sores - a critical single-centre analysis

Int Wound J. 2017 Dec;14(6):1154-1159. doi: 10.1111/iwj.12776. Epub 2017 Jun 29.

Abstract

The development of pressure sores is still not only an enormous economical but also a medical burden. Especially in the ischial region, the local defect coverage remains demanding as it is the main weight-bearing area in wheelchair-mobilised patients and is prone to high mobility. The purpose of our study was to report our long-time experience with the reconstruction of ischial pressure ulcers with the medially based posterior thigh flap. A retrospective analysis of all primary pressure sores grade III-IV in the ischial area, which were covered with a medially based posterior thigh flap between January 2008 and December 2014, at our department was conducted. A total of 28 patients underwent defect coverage of an ischial pressure sore with the aforementioned flap. The subgroup with complications showed a statistically significant longer hospital stay. A statistically significant correlation between age and the coincidence of comorbidities could be seen. Older patients showed significantly higher grades of pressure sores. The medially based posterior thigh flap is a safe and reliable flap design. Complication rates are comparable to other flaps. Nevertheless, in case of complications, a significantly longer duration of hospitalisation has to be taken into account.

Keywords: Fasciocutaneous flap; Ischial pressure sore; Paraplegic; Posterior thigh flap; Tetraplegic.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Ischium
  • Male
  • Middle Aged
  • Plastic Surgery Procedures*
  • Pressure Ulcer / pathology
  • Pressure Ulcer / surgery*
  • Retrospective Studies
  • Surgical Flaps*
  • Thigh
  • Treatment Outcome
  • Wound Healing