title: Comparison of fasciocutaneous V-Y and rotational flaps for defect coverage of sacral pressure sores: a critical single-centre appraisal.
abstract: Pressure sore rates remain high in both nursing homes as well as in hospitals. Numerous surgical options are available for defect coverage in the sacral region. However, objective data is scarce as to whether a specific flap design is superior to another. Here, we aim to compare two fasciocutaneous flap designs for sacral defect coverage: the gluteal rotation flap and the gluteal V-Y flap. All primary sacral pressure sores of grades III-IV that were being covered with gluteal fasciocutaneous rotational or V-Y flaps between January 2008 and December 2014 at our institution were analysed. A total of 41 patients received a total of 52 flaps. Of these, 18 patients received 20 gluteal rotational flaps, and 23 patients received 32 V-Y flaps. Both groups were comparable with regards to demographics, comorbidities and complications. Significantly more V-Y flaps were needed to cover smaller defects. Mean length of hospital stay was significantly prolonged when surgical revision had to be carried out. Both flap designs have proven safe and reliable for defect coverage after sacral pressure sores. Gluteal rotational flaps appear to be more useful for larger defects. Both flap designs facilitate their reuse in case of pressure sore recurrence. Complication rates appear to be comparable in both designs and to the current literature.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.|Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, AGAPLESION Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt am Main, Germany.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Djedovic
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Metzler
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Evi M
authors.initials: EM
authors.lastname: Morandi
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Tanja
authors.initials: T
authors.lastname: Wachter
authors.affiliation: Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, AGAPLESION Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt am Main, Germany.
authors.forename: Shafreena
authors.initials: S
authors.lastname: Kühn
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Pierer
authors.affiliation: Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, AGAPLESION Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt am Main, Germany.
authors.forename: Ulrich M
authors.initials: UM
authors.lastname: Rieger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012445:Sacrococcygeal Region / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps
keywords: Fasciocutaneous flap; Rotational flap; Sacral pressure sore; V-Y flap