RESULTS OF SACRAL PRESSURE SORES SURGICAL CLOSURE BY GLUTEAL SKIN FLAP

Aim: Pressure ulcers are a long-term medical problem; it was even found during the autopsy of Egyptian mummies. This prospective study was conducted to evaluate the surgical outcome of sacral pressure ulcer closure with gluteal skin flaps.

Place and Duration: In the Plastic Surgery department of  Bolan Medical Complex Hospital, Quetta

for six months duration from April 2021 to September 2021.

Methods: The study included 22 patients with stage III and IV pressure ulcers. More than two-thirds (68.2%) of the ulcers were stage III, and more than three-quarters (77.3%) had local signs of infection. While the mean horizontal and vertical length of the cavities before excision were 10.4 and 8.8 cm, respectively, after excision of the dead and dead tissue it increased to 12.6 and 10.6 cm, respectively. The mean medial lobe shift was 6.3 cm.

Results: Postoperative observation of the flap revealed no infection, seroma, or hematoma in any of the patients. Only 2 (9.1%) patients had marginal flap loss. In two cases, marginal flap defects were excised and a direct suture was applied (secondary closure). Over 90% of the patients had good results.

Conclusions: The study found that the gluteal flap gives a good result in the majority of patients with large cruciate wounds, with almost no complications and recurrences. The gluteal flap has advantages such as preserving the musculature, less morbidity at the site of collection, versatility in design, and less extraction effort.

Key words: pressure ulcers, gluteal flap, cross dressing.