Inferior Gluteus Maximus Island Flap for Reconstruction of Ischial Pressure Sores

Abstract

Surgical management of ischial pressure sores has always been a challenge due to high recurrence rate. Ischial pressure sores develop due to unrelieved pressure over the Ischium. Inferior gluteus maximus island flap has been used effectively for coverage of ischial pressure sores.

Objective:  To describe the efficacy of inferior gluteus maximus flap for reconstruction of ischial pressure sores.

Methods:  A retrospective case series, consisted of sample of 17 cases. The study was conducted in the Department of Plastic and Reconstructive Surgery, Post Graduate Medical Institute, Lahore General Hospital Lahore, over a period of 8 years from March 2008 to March 2016. The case series included17 patients with grade 3 and grade 4 ischial pressure sores, comprising 12 male and 5 female, with age range of 28 to 64 (mean = 46 years).Follow-up ranged from 1 to 4 years with a mean of 2.5 years. Inferior gluteus maximus island flap was used for reconstruction of Ischial pressure sores.

Results:  In thirteen (76%) of the seventeen patients, wound healed uneventfully without any complication. Partial wound dehiscence was observed in 2 patients (12%). Both of these healed with conservative wound management. Recurrence was seen in 2 patients (12%) after 8 months. These two patients underwent reoperation and gluteus maximus flap was readvanced that resulted in satisfactory wound coverage.

Conclusion:  Inferior gluteus maximus island flap can be considered as a reliable option for reconstruction of ischial pressure sores.