Perforator-based fasciocutaneous flap for pressure sore reconstruction

J Plast Surg Hand Surg. 2012 Dec;46(6):430-3. doi: 10.3109/2000656X.2012.727823.

Abstract

Pressure sore reconstruction is always a challenge for plastic surgeons due to its high recurrence rate. In addition to the myocutaneous flap, the perforator-based fasciocutaneous flap has become a new entity used for pressure sore reconstruction. This study presents a series of 26 perforator-based fasciocutaneous flaps for pressure sore reconstruction, with good outcomes in 21 patients from July 2008 to April 2011. The flaps were advanced, transposed, or rotated to obliterate the defects. Twenty of 26 flaps healed uneventfully without complication. One patient had a flap that totally necrosed, one had partial flap necrosis (flap rotated 180° in the above two cases), one had infection and healed by a secondary flap, one had minor wound dehiscence, one died of pneumonia 1 week postoperatively, and recurrence developed in one patient. The perforator-based fasciocutaneous flap is a reliable method and produced good results in this series. These flaps are well vascularised, have enough soft tissue bulk, and have a high degree of mobilisation freedom.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Fascia / transplantation
  • Fasciotomy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Perforator Flap / blood supply*
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Pressure Ulcer / diagnosis
  • Pressure Ulcer / surgery*
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Skin Transplantation / adverse effects
  • Skin Transplantation / methods
  • Treatment Outcome
  • Wound Healing / physiology