Island V-Y Tensor Fasciae Latae Fasciocutaneous Flap for Coverage of Trochanteric Pressure Sores

Abstract

The distal fasciocutaneous portion of the lateral thigh is supplied by the direct cutaneous branch of the lateral descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. This consistent vascular anatomy allows raising a distal skin island based on both arteries on the lateral thigh, and this flap can be advanced into a trochanteric defect according to the V-Y technique. Based on anatomic and clinical study, a new design has been developed of the tensor fasciae latae fasciocutaneous flap, which is supplied by two pedicles. Seven island V-Y tensor fasciae latae fasciocutaneous flaps have been used for the coverage of trochanteric pressure sores in six patients. It is believed that the island V-Y tensor fasciae latae fasciocutaneous flap could overcome the traditional drawbacks of the conventional tensor fasciae latae flap and its modifications, and this is an ideal flap for covering trochanteric pressure sores without any donor site deformity and morbidity, which greatly improves the aesthetic result.

The Subcutaneous Pedicle Tensor Fascia Lata Flap for Coverage of Trochanteric Pressure Sores: Surgical Technique

“…14 Some modifications have been developed to overcome the disadvantages of the posterior transposition flap, such as V-Y advancement, the 'duck' modification of the TFL flap, the hatchet-shaped TFL musculocutaneous flap, the bilobed TFL musculocutaneous flap and the TFL perforator flap. [3][4][5][6][7] The subcutaneous pedicle flap was first described by Şafak et al in 1996. 14 In that study, the subcutaneous pedicled flap was employed to cover ischial, trochanteric pressure sores, to reconstruct the lower abdominal wall and for penile reconstruction.…”

“…Several modifications of the TFL flap have been developed to overcome the mentioned drawbacks. [3][4][5][6][7] The subcutaneous pedicle flap not only overcomes these well known disadvantages of the classical TFL flap, but also has additional advantages mostly concerning the cosmetic appearance of both donor and reconstructed sites. In this report, we described our experiences with the use of the subcutaneous pedicled TFL flap for reconstruction of trochanteric pressure sore defects.…”

Pressure sores

“…44 This flap is based on a branch of the lateral circumflex femoral artery and may be composed of muscle and skin or muscle alone. Common options for reconstruction of these defects are flaps based on the tensor fascia lata (TFL) muscle.…”

Tensor Fasciae Latae Perforator Flap: Minimizing Donor-Site Morbidity in the Treatment of Trochanteric Pressure Sores

“…Erçöçen et al 12 described a fasciocutaneous V-Y advancement flap based on the descending branch of the lateral circumflex femoral artery and on the third perforator of the deep femoral artery that spares the local muscles and prevents functional deficit, leaving local options for future coverage. However, it sacrifices the tensor fasciae latae so that a functional deficit remains.…”