Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP MONTAG, Eduardo FMUSP-HC
dc.identifier.citation EUROPEAN JOURNAL OF PLASTIC SURGERY, v.41, n.1, p.41-48, 2018
dc.identifier.issn 0930-343X
dc.description.abstract Background Flap coverage is the gold standard in treating pressure sores, and due to the high recurrence rate, the possibility of multiple surgical procedures should be considered during flap selection. The gluteal thigh (GT) flap has become a workhorse for ischiatic pressure sore treatment at our hospital. Follow-up revealed a group of patients presenting recurrence of the pressure sore that needed a second flap. The inferior gluteal artery perforator (IGAP) flap was chosen in this series. The positive experience with both flaps raised the question of which flap should be the first option for the treatment of ischiatic and perineal pressure sores. Methods IGAP and GT flaps were dissected in 21 fresh human cadavers to allow comparison of anatomical features. In a series of 60 patients, the authors used both the gluteal thigh and the IGAP flap to cover 76 ischiatic and perineal ulcers. Results The IGAP flap was found to be wider and thicker than the gluteal thigh, but presented a shorter pedicle. All flaps healed uneventfully. Recurrent ulcers were treated successfully with both flaps. Conclusions Both flaps are suitable for coverage ischiatic and perineal sores. Due to its anatomical features, the IGAP flap should be considered the first choice of treatment for ischiatic ulcers. The gluteal thigh flap should be used in the recurrent sores.
dc.language.iso eng
dc.publisher SPRINGER
dc.relation.ispartof European Journal of Plastic Surgery
dc.rights restrictedAccess
dc.subject Pressure ulcer; Surgical flaps; Comparative anatomy; Gluteal region; Thigh anatomy
dc.subject.other sacral pressure sores; breast reconstruction; ulcers; artery; closure; management; buttock; wounds; region
dc.title Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps
dc.type article
dc.rights.holder Copyright SPRINGER LIM/04
dc.identifier.doi 10.1007/s00238-017-1371-2
dc.identifier.pmid 29398784
dc.type.category original article
dc.type.version publishedVersion MONTAG, Eduardo:HC:ICESP UEDA, Thiago:HC:ICHC OKADA, Alberto:HC:ICESP GEMPERLI, Rolf:FM:MCG · ONISHI, Bruno:Univ Sao Paulo, Sch Med, Div Plast Surg, Sao Paulo, Brazil WOS:000423152800007 2-s2.0-85047184167 NEW YORK USA
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dc.description.index PubMed
dc.identifier.eissn 1435-0130
hcfmusp.citation.scopus 0
hcfmusp.citation.wos 0 Brasil

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