case_images: PMC2772273_01
case_images: Giant right trochanteric pressure sore with exposed trochanters and gangrenous tensor fascia lata. Doppler identified perforators are marked
case_images: IJPS-42-126-g001.jpg
case_images: PMC2772273_01_IJPS-42-126-g001.jpg
case_images: F0001
case_images: An examination revealed a giant right trochanteric sore measuring 24 x 14 cms [Figure 1]. Preoperative portable Doppler marking of the anterolateral thigh perforator was done and was suggestive of two terminal prominent branches [Figure 1].
case_images: Lateral circumflex femoral artery with branches to skin and vastus lateralis dissected and taped
case_images: IJPS-42-126-g002.jpg
case_images: PMC2772273_01_IJPS-42-126-g002.jpg
case_images: F0002
case_images: This revealed an intact branch to the middle third of the vastus lateralis apart from the skin supply [Figure 2].
case_images: Paddles of vastus (proximal) and skin (distal) raised on perforator branches
case_images: IJPS-42-126-g003.jpg
case_images: PMC2772273_01_IJPS-42-126-g003.jpg
case_images: F0003
case_images: A chimeric flap was pedicled on the lateral circumflex femoral artery using the anterolateral thigh fasciocutaneous and vastus lateralis muscle component on separate perforator branches [Figure 3].
case_images: Muscle component placed proximally over the debrided trochanteric area and fasciocutaneous component placed distally over femur shaft
case_images: IJPS-42-126-g004.jpg
case_images: PMC2772273_01_IJPS-42-126-g004.jpg
case_images: F0004
case_images: The donor site could be primarily closed except a 6 x 2 cms strip over the distal extent, which was also covered by skin graft [Figure 4].
case_images: Well consolidated flaps 2 months after the surgery
case_images: IJPS-42-126-g005.jpg
case_images: PMC2772273_01_IJPS-42-126-g005.jpg
case_images: F0005
case_images: At a 2-month follow-up visit, the flaps were stable with no recurrence of ulceration [Figure 5].