The management of pelvic pressure ulcers by myocutaneous flaps: a 10 years experience in Yaoundé - Cameroon.

Abstract

Pressure ulcers or ischaemic necrosis of tissues over bony eminences due to pressure, heal very slowly. Vascularised tissues such as myocutaneous flaps are necessary to cover the ulcer and accelerate healing. This study was done to share our experience with methods of myocutaneous flaps in the treatment of pressure ulcers. We retrospectively reviewed the outcome of 20 myocutaneous flaps used for the surgical coverage of 24 pelvic pressure ulcers in 18 patients from 1997 to 2007 in the Yaoundé University Hospital Centre (CHUY). The mean patient age was 46.06 years (range: 19-86years). The sex ratio was 5 men for 4 women 10 sacral ulcers were treated by gluteus maximus myocutaneous flaps, 10 trochanteric and 4 ischiatic ulcers were covered by tensor fascia lata myocutaneous flaps. The cure rate was 100%. The main complications were: infection (63.5%), serous fluid discharge (21.05%), and flap edge necrosis (31.6%). Of the 18 patients in the study: 8 were lost to follow up, 1 dead after a week from another disease. The average follows up for the remaining 9 live patients was 20.6 months (range, 1-39 months). No recurrence of pressure ulcer was observed. Myocutaneous flap transposition remains a simple, reliable, effective, safe, versatile and useful method for the coverage of large pelvic pressure ulcers.

Key words : Pressure ulcer, musculo-cutaneous flap, pelvic ulcer.