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Multiple Flaps for Trochanteric Pressure Sore Reconstruction: A Case Series.

Luca Negosanti1, Sara Tedeschi2, Fabio F Trapani2

  • 1Specialized Care Unit, Montecatone Rehabilitation Institute, Imola, ITA.

Cureus
|August 28, 2020
PubMed
Summary

Treating trochanteric pressure sores, especially those with bone involvement, is challenging. Muscle and musculocutaneous flaps effectively reconstruct these large wounds, ensuring complete healing and preventing recurrence in spinal cord-injured patients.

Keywords:
bone infectionflap reconstructionpressure sores

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Area of Science:

  • Orthopedic Surgery
  • Plastic Surgery
  • Rehabilitation Medicine

Background:

  • Trochanteric pressure sores present significant treatment challenges, particularly when extensive bone debridement is necessary.
  • Large, deep residual wounds require meticulous reconstruction to eliminate dead space and ensure adequate tissue coverage.
  • Spinal cord-injured patients are particularly susceptible to these complex pressure sores.

Observation:

  • A case series focused on spinal cord-injured patients with trochanteric pressure sores.
  • Reconstruction involved a combined approach using muscle and a cutaneous thigh muscle flap.
  • The surgical technique aimed to ensure complete wound fill and robust tissue coverage.

Findings:

  • The combined muscle and musculocutaneous flap technique resulted in complete wound healing.
  • No recurrence of the trochanteric pressure sore was observed at an 18-month follow-up.
  • Muscle or musculocutaneous flaps are identified as superior choices for their substantial viable tissue volume.

Implications:

  • This reconstructive strategy offers a viable solution for complex trochanteric pressure sores.
  • The use of muscle and musculocutaneous flaps can improve healing outcomes and reduce recurrence rates.
  • Further research into flap combinations may optimize results for challenging wound reconstructions.