Perforator based flaps for sacral pressure sore A change from convention

Abstract

Pressure sore reconstruction has always
been a challenge for plastic surgeons
due to its recurrence. Traditional local
fasciocutaneous musculocutaneous flaps
have been associated with high recurrence
rate and high morbidity. With the
advent of the perforator-based fasciocutaneous
flaps, the gluteal artery perforator
have become a new and exciting entity
with minimum morbidity and multiple
options of reconstruction for recurrent
problems.This Study was conducted in
our institute in patients who were admitted
for the sacral pressure sore management
due to various causes during the
period from May 2012 to May 2013. This
study presents a series of 8 cases (5
male, 3 female) of perforator-based fasciocutaneous
flaps for sacral pressure
sore reconstruction. The flaps were used
as a propeller to obliterate the defects. 6
of 8 flaps healed uneventfully without any
complications. One patient had a flap
that partially necrosed. One case the flap
totally necrosed. There was no recurrence
during the follow up
of 6 months period. We have modified our
flap by limiting the dissection to the pedicle.
By doing so we can decrease the operative
time considerably, reduce blood loss and
inadvertent damage to the perforator. It can
be even performed by surgeons without
micro vascular training.