Title: Comparison of V-Y advancement fasciocutaneous flaps and Gluteal perforator propeller flaps for reconstruction of sacral pressure sore
Authors: Dr T.V. Subha, Dr R. Vivek MS, MCh, Prof. J. Jaganmohan MS, MCh
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.147
Abstract
Introduction: Pressure sores are a common problem associated with great morbidity and cost. The most common site of occurrence is sacrum in bed ridden patients. Over the years several methods have been used to reconstruct sacral pressure sore. However, no consensus has been reached, regarding their definitive management. Gluteal fasciocutaneous flaps are commonly preferred, because they facilitate the preservation of the gluteal muscle integrity and muscle function and allow for revision in the event of recurrence. In recent years, the development of perforator flap surgery has increased the number of potential donor sites. Gluteal perforator (GP) propeller flap provides healthy tissue with a robust blood supply can be transferred freely without sacrificing the underlying muscle.
Aim and Objective: Comparative studies of GP flap and V-Y fasciocutaneous flap for sacral pressure sore are rarely reported in literature. The purpose of this retrospective study was to analyze the outcome and surgical complications of perforator and V-Y fasciocutaneous flaps and compare them.
Material and Methods: In this retrospective study data is collected from September 2017 to august 2019, 20 patients with stage IV sacral sores underwent reconstruction. In these 10 patients had gluteal perforator propeller flaps and 10 had V-Y advancement fasciocutaneous flaps done. Data collected are age, sex, comorbidity which caused sacral sore, operative time, defect size, time to heal.
Results: Effective analysis done between these two group shows there is no major difference in the outcome and complications in reconstructing sacral sore using either gluteal perforator propeller flap or V-Y advancement fasciocutaneous flap. But there are certain advantages in use of each of these flaps.
Conclusion: This retrospective study shows gluteal perforator propeller flap has more movement compared to V-Y advancement flap, so to reconstruct large defects V-Y flap from either side would be necessary. Perforator propeller flap requires periperforator dissection results in increased operative time. In case of recurrence re-advancement of V-Y flap can be done.
Keywords: V-Y advancement flap, Gluteal perforator flap, sacral pressure sore.
