V-Y advancement hamstring myocutaneous island flap repair of ischial pressure ulcers.
Thirty-seven ischial pressure ulcers were repaired in 27 patients (eight quadriplegic, 19 paraplegic) between 1988-1993 using the V-Y advancement hamstring myocutaneous island flap. Twenty-one ulcers (57%) arose de novo and 16 were recurrent, with five patients having bilateral ulcers. The average duration of the ulcer was 5 months (range 1-30). All ulcers extended through the deep fascia (clinical grade IV), with the average diameter being 4.7 cm (range 2-10). There were four major flap complications (11%). All but one of the ulcers healed at discharge (97%). Mean follow up was 20 months (range 5-54) in 21 patients (78%), with six patients being lost to follow up. Seven of the 21 (33%) patients developed recurrent ulcers, with four of these having flap re-advancement with successful healing, and one patient having two re-advancements. Overall, 18 of the 21 (86%) patients with follow up had healed ulcers at time of follow up. The V-Y advancement hamstring myocutaneous island flap is versatile, reliable, easy to perform, has few complications, and can be re-advanced in the event of recurrence.
Cope
C
C
Department of Plastic and Reconstructive Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Barry
P
P
Hassall
M
M
Barnett
R
R
Richards
M
M
Vandervord
J
J
D006801:Humans; D011183:Postoperative Complications; D003668:Pressure Ulcer / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000379:methods*