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Free flaps for pressure sore coverage.
Vincent Lemaire1, Kevin Boulanger, Oliver Heymans
1Department of Plastic Surgery, University Hospital, Liege, Belgium. vlemaire@chu.ulg.ac.be
Annals of Plastic Surgery
|June 4, 2008
Summary
Free flap surgery offers a viable solution for complex pressure sores when local flaps fail. This technique achieved stable coverage in 80% of patients with recurrent pressure ulcers.
Area of Science:
- Plastic Surgery
- Wound Management
- Microsurgery
Background:
- Recurrent pressure sores pose a significant surgical challenge.
- Limited local tissue options often necessitate advanced reconstructive techniques.
Purpose of the Study:
- To evaluate the efficacy of free flap surgery for pressure sores unresponsive to pedicled flaps.
- To assess outcomes and identify patient factors associated with free flap success in pressure sore management.
Main Methods:
- Retrospective chart review of patients undergoing surgery for sacral, ischial, or trochanteric pressure sores.
- Analysis of 141 flap procedures across 88 patients, with a focus on 6 patients who received free flaps.
- Mean follow-up of 32 months for free flap cases.
Main Results:
- Free flap surgery was utilized in 4.2% of cases for large pressure sores unsuitable for pedicled flaps.
- Stable coverage was achieved in 80% of free flap patients.
- Trends suggested associations between free flap use and diabetes, incontinence, paraplegia, and male sex.
Conclusions:
- Free flap surgery is a valuable option for select patients with extensive or recurrent pressure sores.
- The procedure demonstrated a high success rate for achieving stable wound coverage.
- Further investigation into patient comorbidities influencing free flap outcomes is warranted.
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