Random pattern hatchet flap as a reconstructive tool in the treatment of pressure sores: clinical experience with 36 patients

Abstract

Introduction Pressure sores represent a reconstructive challenge, and the high recurrence rate and need for reoperations should always be considered. Sacrifice of muscle and fascia in primary reconstruction may compromise options for future repairs. The objective of this study was to evaluate the reliability of muscle- and fascia-sparing random pattern hatchet flap reconstruction of pressure sores in different body regions. Methods From November 2017 to December 2019, 36 participants with grade III and IV pressure sores underwent random pattern hatchet flap reconstruction. Early postoperative complications and flap survival were evaluated in follow up for 6–12 months. Results Thirty-six participants with an age range of 15 to 67 years who presented with pressure sores (13 sacral, 12 ischial, 10 trochanteric, and 1 scapular) underwent surgery. Complete healing of sores was observed within 21 days of surgery in 32 cases and within 30 days for the remaining four cases. Postoperative complications (11.2%) were recorded in only four participants: two experienced partial wound dehiscence, one seroma developed in a trochanteric case, and there was one infection in a sacral sore. Conclusions Random pattern hatchet flap is a reliable tool that results in minimal complications for treatment of pressure sores of limited dimensions.

Reconstructive Surgery of Pressure Injuries in Spinal Cord Injury/Disorder Patients: Retrospective Observational Study and Proposal of an Algorithm for the Flap Choice

“…In the case of sacral PI, the flap is always harvested unilaterally for the same reason. In 2017, MJ Alfeehan et al published their experience with muscle- and fascia-sparing random pattern hatchet flaps in the primary reconstruction of pressure sores in different body regions, showing it is a reliable option that does not compromise options for future repairs [ 33 ].…”