Tensor fasciae latae perforator flap: minimizing donor-site morbidity in the treatment of trochanteric pressure sores.
BACKGROUND
To report a new technique with less morbidity for coverage of trochanteric defects, an anatomical and clinical study was performed.


METHODS
Twenty-four fresh cadavers were dissected. The following parameters were measured: origin, location, number, and length of the perforating vessels. In addition, a clinical study was performed on 21 patients with trochanteric pressure sores.


RESULTS
The anatomical study of 24 fresh cadavers revealed the constant presence of perforator pedicles anterior to the greater trochanter, which provides an adequate arc of rotation arc for flap harvest without sacrificing the underlying muscles. The mean length of the pedicles was 9.59 +/- 2.16 cm. This flap is nourished by perforator vessels arising from the ascending branch of the lateral circumflex femoral artery, which arises from the deep femoral artery and runs through the intermuscular septum, tensor fasciae latae, and rectus femoralis muscles. In this study, flaps were raised based on perforators located preoperatively using a unidirectional Doppler probe. Good results were obtained with primary closure of the donor site, with only two donor-site dehiscences.


CONCLUSIONS
This flap is an alternative to myocutaneous flaps, as it preserves local musculature without functional sequelae in patients who walk. It also preserves the local musculature in the event of recurrence, as is usually seen in paralytic patients with pressure sores.
Ishida
Luis H
LH
Division of Plastic Surgery, General Surgery Department, São Paulo University Medical School, São Paulo, Brazil. hap@uol.com.br
Munhoz
Alexandre M
AM
Montag
Eduardo
E
Alves
Helio R N
HR
Saito
Fabio Lopes
FL
Nakamoto
Hugo Alberto
HA
Ferreira
Marcus C
MC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D020858:Tissue and Organ Harvesting