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Long-Term Outcome of Pressure Sores Treated with Flap Coverage

Yamamoto, Yuhei M.D., Ph.D.; Tsutsumida, Arata M.D.; Murazumi, Masahiko M.D.; Sugihara, Tsuneki M.D., Ph.D.

Plastic and Reconstructive Surgery: October 1997 - Volume 100 - Issue 5 - p 1212–1217
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This article provides our experience with 45 ischial sores and 24 sacral sores in 53 paraplegic patients between 1990 and 1995. Data were evaluated as to the sites of sores and types of the transferred flaps. Types of the transferred flaps were categorized into the fasciocutaneous flap and the myocutaneous or muscle Hap. In the treatment of 45 ischial sores, 18 were reconstructed with the fasciocutaneous flaps and 27 with the myocutaneous or muscle flaps. In the treatment of 24 sacral sores, 23 were reconstructed with the fasciocutaneous flaps and 1 with the myocutaneous flap. The recurrence rate was analyzed by percent pressure sore free survival (%PSFS) by the Kaplan-Meier method. Overall, the ischial sores provided a higher recurrence rate than sacral sores; however, there was no significant difference in the %PSFS between the sites of sores. The group of the sores reconstructed with the fasciocutaneous flap demonstrated significant or marginally significant better results in the %PSFS (total of ischial and sacral, p = 0.0155; ischial, p = 0.0555) compared with the group of the sores reconstructed with the myocutaneous or muscle flap. These findings indicated that the use of the fasciocutaneous flap is expected to provide a better longterm result in surgical reconstruction of pressure sores than the myocutaneous or muscle flap. (Plast. Reconstr. Surg. 100: 1212, 1997.)

Sapporo, Japan

From the Department of Plastic and Reconstructive Surgery, School of Medicine, Hokkaido University. Received for publication May 10, 1996; revised November 12, 1996.

Yuhei Yamamoto, M.D.

Department of Plastic and Reconstructive Surgery

Hokkaido University, School of Medicine

Kita 15, Nishi 7, Kitaku

Sapporo, 060, Japan

©1997American Society of Plastic Surgeons