The recurrent neurotrophic buttock ulcer in the meningomyelocele paraplegic: a sensate flap solution.
A large percentage of meningomyelocele paraplegic patients have a distal zone of sensation-bearing skin on their thighs. This sensate skin can be used as a fasciocutaneous flap to resurface a recidivistic ulcer after excision. In this study, because the transposition distance was significant, the flap length-width ratio was greater than normal and, therefore, required a 3-week elevation delay. This also permitted appraisal of the sensate flap after the first stage. The wound-healing was excellent after both stages. This reconstructive procedure was completed in four patients, with an average follow-up period of 13 years. These patients remain chronic sitters in administrative jobs and have been pressure sore-free after flap repair.
Thomson
H G
HG
Department of Surgery, The Hospital for Sick Children, University of Toronto, Canada. thomsons44@aol.com
Azhar Ali
M
M
Healy
H
H
D000293:Adolescent; D000328:Adult; D002081:Buttocks; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000601:surgery; D010264:Paraplegia / Q000209:etiology; D003668:Pressure Ulcer / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012677:Sensation / Q000502:physiology; D013524:Surgical Flaps; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology