Rhomboid flaps in surgery for decubital ulcers: indications and results

Fasciocutaneous or musculocutaneous flaps have greatly enlarged the scope of surgical possibilities for repairing a decubital ulcer. In paralyzed patients, however, one must always reckon with recurrences, so larger flaps, which are often prone to complications, should be saved for possible recurrence. The use of muscle flaps in partially paralyzed patients or in patients recovering from neurological injury may lead to functional loss. The Limberg (rhomboid) flap is a very reliable surgical method in which the donor site and the associated tension in tissue lie outside the weight-carrying areas; the donor site lies in the perineal area, which is never used for other flaps. Our experience is presented with 23 Limberg flaps in 21 patients in a series of 103 operated decubital ulcers in 73 patients.