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A One-Size-Fits-All Approach to Pressure Ulcers: Whole-Buttock Fasciocutaneous Advancement Flap
Jill Chen1, Jian-An Chen2, Chien-Chung Chen1
1From the Department of Plastic and Reconstructive Surgery, E-Da Hospital, I-Shou University.
Annals of Plastic Surgery
|April 19, 2023
Summary
This study presents a simple, versatile whole-buttock fasciocutaneous flap for treating gluteal pressure injuries. The technique offers a high success rate, simplifying reconstruction for complex wounds.
Area of Science:
- Plastic Surgery
- Wound Reconstruction
- Pressure Injury Management
Background:
- Buttock pressure injuries present significant treatment challenges.
- Existing flap options for reconstruction are often limited in size, technical simplicity, or recyclability.
Purpose of the Study:
- To evaluate the efficacy of a large, whole-buttock fasciocutaneous flap for surgical reconstruction of buttock pressure injuries.
- To demonstrate the flap's adaptability to various ulcer locations and sizes, and its suitability for treating recurrences.
Main Methods:
- Retrospective review of 50 patients undergoing 54 flap reconstructions for gluteal pressure injuries (2013-2018).
- Utilized a 'one-size-fits-all' fasciocutaneous rotational flap technique.
- Key steps included oversized flap elevation, tension-free closure, V-Y closure placement, and negative wound therapy.
Main Results:
- Successful reconstruction in 74% of cases without further surgery.
- Average defect size was 90 cm², with an average follow-up of 31 months.
- Four flaps were recycled for recurrent ulcers or wound dehiscence.
Conclusions:
- The whole-buttock fasciocutaneous flap is a recommended, simple, and effective surgical approach for selected patients with gluteal pressure injuries.
- This technique provides a reliable and adaptable solution for complex pressure sore reconstruction.
