TWO YEARS WOUND FREE TO FOLLOW UP OF A CHRONIC PRESSURE SORE IN A PARAPLEGIC PATIENT AFTER PERFORMING THREE MUSCLE FLAPS: A CASE REPORT
Hawre A. Hassan a, Ari R. Qader b, Vyan H. Mohammed Raouf a, and Shakhawan S. Zorb a
a Sulaimani Burn, Plastic and Reconstructive Surgery Hospital, Ministry of Health, Kurdistan Region, Iraq.
b Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
Submitted: 29/3/2021; Accepted: 31/7/2021; Published: 21/12/2021
DOI Link: https://doi.org/10.17656/jsmc.10337
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.
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.
Our two years follow up showed that this method is effective for the management of large deep ischial pressure sores with no recurrence.
Pressure sore, Musculocutaneous flap, Osteomyelitis.
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