The Need for Skin and Muscle Saving Techniques in the Repair of Decubitus Ulcers

Abstract

The authors report on a consecutive series of 72 patients during the period 1979–1984 presenting 100 important decubitus ulcers with a follow-up of at least one year. The repair of decubitus ulcers in paraplegic patients often requires a prolonged stay in hospital and multiple operations, since the lesions are frequently multiple. Local and general conditions make it imperative for the surgeon to choose a safe technique, with minimal tissue damage and above all leaving enough healthy skin and muscle for possible future repairs, especially in paraplegic patients. The various techniques are described according to the location of the decubitus ulcers. The following myocutaneous island flaps have been used: for sacral ulcers gluteus maximus flap; for ischial ulcers biceps femoris flap and for trochanteric ulcers tensor fascia lata flap. The authors insist on good long-term results with early social rehabilitation and prevention of recurrence, especially in paraplegic patients.

Key Words:

• pressure sores
• myocutaneous flap
• respect of reconstructive units
• economy of skin and muscle flaps