title: A new technique of transferring island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of recurrent ischial pressure sores.
abstract: We describe island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of the difficult, recurrent ischial pressure sore. Rather than transfer through a subcutaneous tunnel, the flap is transferred directly through the upper thigh to the ischial defect. A total of 15 patients with 16 recurrent ischial pressure sores were treated between May 2003 and April 2005. Eleven sores were treated with pedicled island anterolateral thigh flaps and five sores with vastus lateralis myocutaneous flaps. There was no difficulty in transferring the flap to reach the ischial defect in any patient. The length of the pedicle ranged from 8.5 to 14 cm. All donor sites were closed primarily. Fifteen of the 16 flaps survived completely. Total necrosis occurred in one vastus lateralis myocutaneous flap, which was located at the distal third of the thigh. We conclude this flap can be added to the repertoire for the treatment of recurrent, difficult ischial pressure sores.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwain. ljt1225@ms43.hinet.net
authors.forename: Jiunn-Tat
authors.initials: JT
authors.lastname: Lee
authors.forename: Li-Fu
authors.initials: LF
authors.lastname: Cheng
authors.forename: Chih-Ming
authors.initials: CM
authors.lastname: Lin
authors.forename: Chien-Hsing
authors.initials: CH
authors.lastname: Wang
authors.forename: Chieh-Chi
authors.initials: CC
authors.lastname: Huang
authors.forename: Sou-Hsin
authors.initials: SH
authors.lastname: Chien
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007512:Ischium; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D003668:Pressure Ulcer / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012008:Recurrence; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D016896:Treatment Outcome