Gluteus maximus island flap for the repair of sacral pressure sores

Abstract

Surgical management of decubitus ulcers in spinal cord injured patients (SCI) has been considerably improved by the application of muscle, myocutaneous and fasciocutaneous flaps. The goal of the present study was to do a critical analysis of the use of a gluteus maximus island flap for sacral pressure sores in paralysed as well as nonparalysed patients. In a prospective study, 34 patients with sacral pressure sores from grade V to VII were treated by gluteus maximus myocutaneous island flaps. Follow up ranged from 1.8 years to 6.2 years. Results were evaluated according to criteria based on (i) extent of wound dehiscence (ii) flap necrosis (iii) recurrence. Final results were excellent to good in 30 cases (88.3%). Poor results occurred in two patients (5.8%) and recurrence in one (2.9%) due to a major flap necrosis. Postoperative infection and wound dehiscence occurred in two cases each. No systemic complications occurred except for one patient who died from uraemia. The rehabilitation of these patients was improved. The postoperative duration of stay in hospital was from 18 to 32 days (mean: 22.5 days). The majority of the patients were quite pleased with the operation.