Ischial pressure ulcers: long-term outcome of 2 surgical techniques

Ann Plast Surg. 2014 Dec;73(6):686-91. doi: 10.1097/SAP.0b013e31828587f0.

Abstract

Background: The aim of our study was to analyze which of these 2 techniques (biceps femoris myocutaneous flap vs gluteus maximus myocutaneous flap) gave the best result for ischial pressure ulcers treatment.

Methods: A retrospective comparative analysis of medical records for stage III and IV pressure ulcers was conducted between the 2 groups by Fisher exact test for categorical variables (significance level P <0.05) followed by a survival analysis by the Kaplan-Meier method.

Results: Twenty-five patients were treated with biceps femoris flap against 8 patients with gluteus maximus flap, primary healing was obtained without complications in 32% of cases in biceps femoris group versus 62.5% in gluteus maximus group. No surgical techniques were statistically correlated with a lower recurrence (32% vs 0%, P = 0.152).

Conclusions: We had no significant difference in recurrence rate between the 2 flaps. However, we had less morbidity in gluteus maximus flap group; indeed, we had zero rate of reoperation and a zero rate of recurrence. For that reason, we think that gluteus maximus flap seems to be the best technical coverage of ischial pressure ulcers.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Buttocks
  • Female
  • Follow-Up Studies
  • Humans
  • Ischium
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocutaneous Flap*
  • Plastic Surgery Procedures / methods*
  • Pressure Ulcer / surgery*
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome