Redesigning to V-Y Fasciocutaneous Flaps: Optimizing Outcomes in Patients With Pressure Injuries and Spinal Cord...

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Wound Healing

Background:

• Surgical treatment for stage 4 pressure injuries in spinal cord injury patients is challenging due to high complication rates.
• Existing V-Y fasciocutaneous flap descriptions lack standardization, hindering reproducible outcomes.
• A need exists for a simplified, effective flap technique for these complex wounds.

Purpose of the Study:

• To introduce and evaluate a novel, simplified V-Y fasciocutaneous flap technique.
• To assess the efficacy of this technique in patients with stage 4 pressure injury and spinal cord injury.
• To provide a standardized, reproducible method for V-Y flap design and execution.

Main Methods:

• A simplified V-Y fasciocutaneous flap technique was developed and applied to 57 flaps in 40 patients.
• The technique involves standardized marking, tracing, dissection, and advancement steps.
• Outcomes were evaluated based on defect coverage, linear advancement, and complication rates.

Main Results:

• The technique achieved significant defect coverage (up to 196.35 cm²) and linear advancement (up to 12 cm).
• Complication and recurrence rates were comparable to other reported flap types.
• Notably, the technique avoided instances of full or partial flap necrosis.

Conclusions:

• The simplified V-Y fasciocutaneous flap technique is effective and reproducible for managing stage 4 pressure injuries in spinal cord injury patients.
• Its ease of execution and favorable outcomes make it a preferred local flap option.
• The technique is versatile and applicable to various defect sizes across different anatomical regions.