TWO YEARS WOUND FREE TO FOLLOW UP OF A CHRONIC PRESSURE SORE IN A PARAPLEGIC PATIENT AFTER PERFORMING THREE MUSCLE FLAPS: A CASE REPORT

Volume 11 , Issue 4 , December 2021 , Pages 503-507

Authors

Hawre A. Hassan 1 ; Ari R. Qader 2 ; Vyan H. Mohammed Raouf 1 ; Shakhawan S. Zorb 1

1 Sulaimani Burn, Plastic and Reconstructive Surgery Hospital, Ministry of Health, Kurdistan Region, Iraq.

2 Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10337

Keywords

Abstract

Background
Joint involvement underlying pressure sore is a challenge to manage because of the extensive tissue damage that
usually requires wide debridement leaving behind significant defects to fill and the possibility of recurrence
after reconstruction.
Case presentation
We present a case of large communicating ischial and trochanteric pressure sore with femoral head osteomyelitis
in a paraplegic patient that was managed by femoral head resection and a musculocutaneous flap instead of
lower limb amputation. Management of chronic pressure sores in neglected spinal cord injury patients requires
teamwork to prevent a recurrence. We could give our patient a chance and save her lower limb from amputation
by a combined vastuslateralis, vastusintermedius and rectus femoris flap (‘three muscle flap’) based on the
lateral circumflex femoral artery following proximal femoral resection.
Conclusion
Our two years follow up showed that this method is effective for the management of large deep ischial pressure
sores with no recurrence.

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  • Published at21 December 2021

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