Lumbosacral rotation flap: a simple method for covering sacral pressure injuries

Area of Science:

• Plastic Surgery
• Wound Management
• Reconstructive Surgery

Background:

• Pressure injuries (PIs) are common in immobile patients.
• PI prevention is key, but recurrence presents management challenges.
• A multidisciplinary approach is essential for effective PI care.

Purpose of the Study:

• To describe the lumbosacral rotation flap (LSRF) technique for sacral PI coverage.
• To evaluate the efficacy and outcomes of LSRF in treating sacral PIs.

Main Methods:

• Retrospective analysis of prospectively collected data from a single center.
• Inclusion of patients undergoing LSRF for sacral PIs.
• Exclusion of patients with sepsis, immune compromise, or organ dysfunction; preoperative optimization and wound cultures were performed.

Main Results:

• Nine patients (7 male, 2 female; mean age 47.6 years) underwent LSRF for sacral PIs (mean size 92.9 cm²).
• Osteomyelitis was present in three patients.
• Two flaps had minor marginal necrosis managed conservatively; all flaps healed well without loss or secondary procedures.

Conclusions:

• Lumbosacral rotation flap (LSRF) is a viable first-line treatment for sacral PIs.
• LSRF can effectively cover large sacral defects.
• The flap's design allows for potential readvancement in cases of PI recurrence.