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A Journal on Surgery

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Chirurgia 2002 August-October;15(4-5):143-6


language: Italian

Surgical treatment of pressure sores: experience in 333 cases

Margara A., Merlino G., Bergamin F., Borsetti M., Borsetti G.


Background. Pressure sores are one of the most common complications following spinal injuries or of other neurological problems. A 15-years' experience of pressure sores treated with myocutaneous flaps is presented.
Methods. From 1985 to November 2000, 333 pressure sores were treated (141 sacral, 67 trochanteric, 112 ischial, 7 calcaneal and 6 confluent). The results obtained in group A (1985-1992) patients not-treated with the protocol in exam were compared with those obtained in group B (1992-2000) using the protocol ''a specific flap for a specific anatomical area''.
Results. Satisfactory results in both the ischiatic and sacral ulcers were obtained. Trochanteric ulcers had the same results as group A. An analysis of the data showed the 30 recurrences (9%) were caused by negligence of the patient, post-operative complications, uncorrect surgical treatment, tumoral recurrences and the lack of a qualified home assistance.
Conclusions. On the basis of personal experience, the VY advancement hamstring myocutaneous flap is suggested as first choice in the ischiatic ulcer. For sacral ulcers, the use of a VY myocutaneous advancement flap of gluteus maximus muscle is preferred. In the trochanteric ulcers the rotation of tensor fascia lata muscle is most frequently used. This experience supports the use of these flaps in the treatment of pressure sores in para and tetraplegic patients.

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