Comparison of hatchet-shaped tensor fascia lata flap and pedicle anterior lateral thigh flap for treatment of trochanteric sores: a retrospective analysis of 48 patients.
OBJECTIVE
Surgical reconstruction of trochanteric sores remains a formidable task for plastic surgeons. Diverse types of flaps have been proposed for use in this situation, each with particular advantages and limitations. This study aimed to compare the surgical outcomes between the hatchet-shaped tensor fascia lata (TFL) flap and the pedicle anterior lateral thigh (ALT) flap in treatment of trochanteric sores.


METHODS
Forty-eight patients with trochanteric sores were operated on under spinal or general anesthesia using TFL or ALT flaps between August 2007 and November 2010. In the TFL group, 26 hatchet-shaped TFL musculocutaneous flaps were performed on 24 patients. In the ALT group, 25 pedicle ALT musculocutaneous flaps were performed on 24 patients. Surgical outcomes were retrospectively analyzed.


RESULTS
No significant difference was detected between the TFL and ALT groups in terms of age, preoperative disease period, obesity (body mass index), American Society of Anesthesiologists score, comorbidity, the defect size, follow-up time, and complication rate. The recurrence rate and the flap size were significantly higher in the TFL group than in the ALT group (P = 0.022; P < 0.001). The operation time was longer in the ALT group (P < 0.001).


CONCLUSIONS
The pedicle ALT flap is a more effective treatment than the TFL flap for the surgical management of trochanteric sores. The hatchet-shaped TFL flap should be reserved for the reconstruction of recurrent trochanteric sores or for use in the critically ill patient who cannot tolerate longer anesthesia and operation time.
From the Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chun-Chang
CC
Li
Shun-Cheng
SC
Chang
Ju-Peng
JP
Fu
Yuan-Sheng
YS
Tzeng
Chih-Hsing
CH
Wang
Tim-Mo
TM
Chen
Shyi-Gen
SG
Chen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005206:Fascia Lata; D005260:Female; D005269:Femur; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap; D003668:Pressure Ulcer / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013848:Thigh; D016896:Treatment Outcome