Ashraf Ganatra, Parvez Anjum, Maratib Ali.
Closure of pressure sores with local flaps.
J Pak Orthop Assoc Jan ;21(1):21-6.

Objective: To assess the clinical presentation and surgical management of patients with pressures sores involving the sacral, ischial and trochanteric regions with local flaps. Study Design: A descriptive case series. Setting & Period: Department of Plastic Surgery & Orthopaedic, Dow University of Health Sciences & Civil Hospital, Karachi, during January 2002 to December, 2005. Patients & Methods: All patients with pressure sores referred from different specialties during four years were studied with regard to their age and etiology of bed ridden. Examination of pressure sore was done with regard to its site, size, depth and mobility of floor. Surrounding area was also examined with a view for the raising of flaps. Three types of local flaps were used. Gluteus Maximus Musculocutaneous & Fascio cutaneous for sacral sores, Posterior thigh flap for ischial sores and Skin Rotation flap for trochanteric sores. Results: Only ten cases were operated. Seven were males and three were females. Age vary from 8 to 50 years Gluteus Maximus musculo- cutaneous flap was used in two and gluteus maximus fascio-cutaneous flap was used in four cases., Transposition thigh flap was used in two cases and skin rotation flap was used in two cases. There were complete flap survivals in all cases of gluteus maximus flaps. But in posterior thigh flaps there were tip necrosis in both cases. There was complete failure in rotation skin flap in one case. Conclusion: The management of pressure sores lies basically in its prevention. However when operated in our series Gluteus maximus flap results were far more then other two types of local flaps.

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