Ischial pressure ulcers: long-term outcome of 2 surgical techniques

The aim of our study was to analyze which of these 2 techniques (biceps femoris myocutaneous flap vs gluteus maximus myocutaneous flap) gave the best result for ischial pressure ulcers treatment.

A retrospective comparative analysis of medical records for stage III and IV pressure ulcers was conducted between the 2 groups by Fisher exact test for categorical variables (significance level P <0.05) followed by a survival analysis by the Kaplan-Meier method.

Twenty-five patients were treated with biceps femoris flap against 8 patients with gluteus maximus flap, primary healing was obtained without complications in 32% of cases in biceps femoris group versus 62.5% in gluteus maximus group. No surgical techniques were statistically correlated with a lower recurrence (32% vs 0%, P = 0.152).

We had no significant difference in recurrence rate between the 2 flaps. However, we had less morbidity in gluteus maximus flap group; indeed, we had zero rate of reoperation and a zero rate of recurrence. For that reason, we think that gluteus maximus flap seems to be the best technical coverage of ischial pressure ulcers.