Reconstruction of Recurrent Pressure Sores Using Free Flaps

Abstract

The authors describe two successful reconstructions of recurrent pressure sores with free fasciocutaneous flaps. In Case 1, a free lateral thigh flap pedicled on the first and third direct cutaneous branches of the deep femoral vessels was used to cover a large recurrent sacral pressure sore. The vascular pedicle was dissected to the deep femoral trunk proximally and anastomosed to the inferior gluteal vessels. In Case 2, a free medial plantar flap was transferred to a recurrent ischial pressure sore. The vascular pedicle was dissected to the posterior tibial vessels proximally. The long vascular pedicle of the flap was passed through the femoral subcutaneous tunnel, and end-to-side microvascular anastomoses were performed to the superficial femoral trunk without any vein grafts. The authors advocate the use of free tissue transfer for recurrent pressure sore reconstruction.

Biceps Femoris Perforator Free Flap for Upper Extremity Reconstruction: Anatomical Study and Clinical Series

“…6 The posterolateral skin of the thigh has been used for free tissue transfer in head and neck reconstruction, with very few reports on its use in nononcologic reconstruction. 23,24 For head and neck surgery, it has been reported to be a thin flap, easy to elevate, far from the recipient area (double team approach), and relatively long pedicled. 5 In this indication, the posterolateral thigh flap may not have advantages over the more popular and widely used anterolateral thigh flap.…”

Plastisch-rekonstruktive Verfahren in der interdisziplinären Therapie chronischer Wunden

“…Als letzte therapeutische Option bleiben bei sehr ausgedehnten Druckgeschwüren freie mikrovaskuläre Lappenplastiken, auch wenn die Anwendung nur vereinzelt beschrieben ist [33,93]. Eigene Erfahrungen zeigen jedoch, dass auf diese Weise mit einem hohen Aufwand auch ausgedehnteste Defekte zu rekonstruieren sind, obwohl manchmal der Kontakt der Lappenplastik zum Untergrund problematisch zu sein scheint.…”

Plantare neurovaskuläre Filetlappenplastik

“…Mikrochirurgische Techniken haben das Spektrum zur Rekonstruktion von Dekubitalulzera erheblich erweitert [19,23]. Zudem wurden verschiedene Möglichkeiten der Wiederherstellung der Sensibilität der betroffenen Region beschrieben.…”