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Ischial Pressure Ulcers: Long-Term Outcome of 2 Surgical Techniques

Bertheuil, Nicolas MD*†; Aillet, Sylvie MD*; Heusse, Jean-Laurent MD*; Tawfik, Mamdouh MD; Campillo-Gimenez, Boris MD§; Watier, Eric MD, PhD*

doi: 10.1097/SAP.0b013e31828587f0
Reconstructive Surgery

Background The aim of our study was to analyze which of these 2 techniques (biceps femoris myocutaneous flap vs gluteus maximus myocutaneous flap) gave the best result for ischial pressure ulcers treatment.

Methods A retrospective comparative analysis of medical records for stage III and IV pressure ulcers was conducted between the 2 groups by Fisher exact test for categorical variables (significance level P < 0.05) followed by a survival analysis by the Kaplan-Meier method.

Results Twenty-five patients were treated with biceps femoris flap against 8 patients with gluteus maximus flap, primary healing was obtained without complications in 32% of cases in biceps femoris group versus 62.5% in gluteus maximus group. No surgical techniques were statistically correlated with a lower recurrence (32% vs 0%, P = 0.152).

Conclusions We had no significant difference in recurrence rate between the 2 flaps. However, we had less morbidity in gluteus maximus flap group; indeed, we had zero rate of reoperation and a zero rate of recurrence. For that reason, we think that gluteus maximus flap seems to be the best technical coverage of ischial pressure ulcers.

From the *Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud; †INSERM U917, University of Rennes 1, Rennes, France; ‡Department of Surgery, General Hospital, Ismailia, Egypt; and §Department of Medical Informatics, Pontchaillou Hospital, University of Rennes 1, Rennes, France.

Received September 25, 2012, and accepted for publication, after revision, December 31, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Nicolas Bertheuil, MD, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, 16 Boulevard de Bulgarie, 35200 Rennes, France. E-mail:

© 2014 by Lippincott Williams & Wilkins