We describe island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of the difficult, recurrent ischial pressure sore. Rather than transfer through a subcutaneous tunnel, the flap is transferred directly through the upper thigh to the ischial defect. A total of 15 patients with 16 recurrent ischial pressure sores were treated between May 2003 and April 2005. Eleven sores were treated with pedicled island anterolateral thigh flaps and five sores with vastus lateralis myocutaneous flaps. There was no difficulty in transferring the flap to reach the ischial defect in any patient. The length of the pedicle ranged from 8.5 to 14 cm. All donor sites were closed primarily. Fifteen of the 16 flaps survived completely. Total necrosis occurred in one vastus lateralis myocutaneous flap, which was located at the distal third of the thigh. We conclude this flap can be added to the repertoire for the treatment of recurrent, difficult ischial pressure sores.
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- The free thigh flap: A new free flap concept based on septocutaneous artery.Br J Plast Surg. 1984; 37: 149-159
- Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation.Plast Reconstr Surg. 2000; 105: 2349-2357
- Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps.Plast Reconstr Surg. 2002; 109: 2219-2226
- Anterolateral thigh fasciocutaneous flap in the difficult perineogenital reconstruction.Plast Reconstr Surg. 2000; 105: 171-173
- Uterine liposarcoma invading abdominal wall and inguinal region. Immediate reconstruction using a pedicled anterolateral thigh flap.Ann Chir Plast Esthet. 2003; 48: 180-186
- Use of vastus lateralis muscle flap for repair of trochanteric pressure sores.Plast Reconstr Surg. 1977; 60: 364-368
- The use of the vastus lateralis musculocutaneous flap for the repair of trochanteric pressure sores.Ann Plast Surg. 1983; 10: 359-363
- The vastus lateralis myocutaneous flap.Plast Reconstr Surg. 1987; 79: 560-566
- Vastus lateralis myocutaneous flap for reconstruction of defects around the groin and pelvis.Br J Surg. 1990; 77: 1275-1277
- Applications of the pedicled vastus lateralis flap for patients with complicated pressure sores.Spinal Cord. 1997; 35: 437-442
- The use of a vastus lateralis muscle flap to repair a gluteal defect.Br J Plast Surg. 1983; 36: 319-321
- The free vastus lateralis flap: An anatomic study with case reports.Plast Reconstr Surg. 1992; 89: 469-475
- Indications for the vastus lateralis flap in oral and maxillofacial surgery.Br J Oral Maxillofac Surg. 1998; 36: 358-364
Published online: May 11, 2007
Accepted: March 26, 2007
Received: May 10, 2006
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.