Comparison of hatchet-shaped tensor fascia lata flap and pedicle anterior lateral thigh flap for treatment of trochanteric sores: A retrospective analysis of 48 patients

Chun-Chang Li, Shun-Cheng Chang, Ju-Peng Fu, Yuan-Sheng Tzeng, Chih-Hsin Wang, Tim-Mo Chen, Shyi-Gen Chen

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

PURPOSE: Surgical reconstruction of trochanteric sores remains a formidable task for plastic surgeons. Diverse types of flaps have been proposed for use in this situation, each with particular advantages and limitations. This study aimed to compare the surgical outcomes between the hatchet-shaped tensor fascia lata (TFL) flap and the pedicle anterior lateral thigh (ALT) flap in treatment of trochanteric sores. METHODS: Forty-eight patients with trochanteric sores were operated on under spinal or general anesthesia using TFL or ALT flaps between August 2007 and November 2010. In the TFL group, 26 hatchet-shaped TFL musculocutaneous flaps were performed on 24 patients. In the ALT group, 25 pedicle ALT musculocutaneous flaps were performed on 24 patients. Surgical outcomes were retrospectively analyzed. RESULTS: No significant difference was detected between the TFL and ALT groups in terms of age, preoperative disease period, obesity (body mass index), American Society of Anesthesiologists score, comorbidity, the defect size, follow-up time, and complication rate. The recurrence rate and the flap size were significantly higher in the TFL group than in the ALT group (P = 0.022; P <0.001). The operation time was longer in the ALT group (P <0.001). CONCLUSIONS: The pedicle ALT flap is a more effective treatment than the TFL flap for the surgical management of trochanteric sores. The hatchet-shaped TFL flap should be reserved for the reconstruction of recurrent trochanteric sores or for use in the critically ill patient who cannot tolerate longer anesthesia and operation time. © 2013 by Lippincott Williams & Wilkins.
Original languageEnglish
Pages (from-to)659-663
Number of pages5
JournalAnnals of Plastic Surgery
Volume71
Issue number6
DOIs
Publication statusPublished - 2013
Externally publishedYes

Fingerprint

Fascia Lata
Thigh
Myocutaneous Flap
Therapeutics
Preoperative Period
Surgical Flaps
Spinal Anesthesia
Critical Illness
General Anesthesia
Comorbidity
Body Mass Index
Anesthesia
Obesity
Recurrence

Keywords

  • anterior lateral thigh flap
  • pressure sore
  • tensor fascia lata flap
  • trochanteric sore
  • adult
  • aged
  • article
  • case report
  • comparative study
  • decubitus
  • evaluation study
  • fascia lata
  • female
  • femur
  • follow up
  • human
  • male
  • methodology
  • middle aged
  • myocutaneous flap
  • plastic surgery
  • retrospective study
  • thigh
  • treatment outcome
  • very elderly
  • Adult
  • Aged
  • Aged, 80 and over
  • Fascia Lata
  • Female
  • Femur
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocutaneous Flap
  • Pressure Ulcer
  • Reconstructive Surgical Procedures
  • Retrospective Studies
  • Thigh
  • Treatment Outcome

Cite this

Comparison of hatchet-shaped tensor fascia lata flap and pedicle anterior lateral thigh flap for treatment of trochanteric sores: A retrospective analysis of 48 patients. / Li, Chun-Chang; Chang, Shun-Cheng; Fu, Ju-Peng; Tzeng, Yuan-Sheng; Wang, Chih-Hsin; Chen, Tim-Mo; Chen, Shyi-Gen.

In: Annals of Plastic Surgery, Vol. 71, No. 6, 2013, p. 659-663.

Research output: Contribution to journalArticle

Li, Chun-Chang ; Chang, Shun-Cheng ; Fu, Ju-Peng ; Tzeng, Yuan-Sheng ; Wang, Chih-Hsin ; Chen, Tim-Mo ; Chen, Shyi-Gen. / Comparison of hatchet-shaped tensor fascia lata flap and pedicle anterior lateral thigh flap for treatment of trochanteric sores: A retrospective analysis of 48 patients. In: Annals of Plastic Surgery. 2013 ; Vol. 71, No. 6. pp. 659-663.
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abstract = "PURPOSE: Surgical reconstruction of trochanteric sores remains a formidable task for plastic surgeons. Diverse types of flaps have been proposed for use in this situation, each with particular advantages and limitations. This study aimed to compare the surgical outcomes between the hatchet-shaped tensor fascia lata (TFL) flap and the pedicle anterior lateral thigh (ALT) flap in treatment of trochanteric sores. METHODS: Forty-eight patients with trochanteric sores were operated on under spinal or general anesthesia using TFL or ALT flaps between August 2007 and November 2010. In the TFL group, 26 hatchet-shaped TFL musculocutaneous flaps were performed on 24 patients. In the ALT group, 25 pedicle ALT musculocutaneous flaps were performed on 24 patients. Surgical outcomes were retrospectively analyzed. RESULTS: No significant difference was detected between the TFL and ALT groups in terms of age, preoperative disease period, obesity (body mass index), American Society of Anesthesiologists score, comorbidity, the defect size, follow-up time, and complication rate. The recurrence rate and the flap size were significantly higher in the TFL group than in the ALT group (P = 0.022; P <0.001). The operation time was longer in the ALT group (P <0.001). CONCLUSIONS: The pedicle ALT flap is a more effective treatment than the TFL flap for the surgical management of trochanteric sores. The hatchet-shaped TFL flap should be reserved for the reconstruction of recurrent trochanteric sores or for use in the critically ill patient who cannot tolerate longer anesthesia and operation time. {\circledC} 2013 by Lippincott Williams & Wilkins.",
keywords = "anterior lateral thigh flap, pressure sore, tensor fascia lata flap, trochanteric sore, adult, aged, article, case report, comparative study, decubitus, evaluation study, fascia lata, female, femur, follow up, human, male, methodology, middle aged, myocutaneous flap, plastic surgery, retrospective study, thigh, treatment outcome, very elderly, Adult, Aged, Aged, 80 and over, Fascia Lata, Female, Femur, Follow-Up Studies, Humans, Male, Middle Aged, Myocutaneous Flap, Pressure Ulcer, Reconstructive Surgical Procedures, Retrospective Studies, Thigh, Treatment Outcome",
author = "Chun-Chang Li and Shun-Cheng Chang and Ju-Peng Fu and Yuan-Sheng Tzeng and Chih-Hsin Wang and Tim-Mo Chen and Shyi-Gen Chen",
note = "被引用次數:1 Export Date: 21 March 2016 CODEN: APCSD 通訊地址: Chen, S.-G.; Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Rd, Sec 2, Taipei 114, Taiwan; 電子郵件: shyigen@gmail.com 參考文獻: Nahai, F., Silverton, J.S., Hill, H.L., The tensor fasciae lata musculocutaneous flap (1978) Ann Plast Surg., 1, pp. 372-379; Paletta, C.E., Freedman, B., Shehadi, S.I., The V-Y tensor fasciae latae musculocutaneous flap (1989) Plast Reconstr Surg., 83, pp. 852-857; Erconen, A.R., Apaydin, I., Emiroglu, M., Island V-Y tensor fasciae latae fasciocutaneous flap for the coverage of trochanteric pressure sores (1998) Plast Reconstr Surg., 102, pp. 1524-1531; Siddiqui, A., Wiedrich, T., Lewis, V., Tensor fasciae lata V-Y retroposition myocutaneous flap: Clinical experience (1993) Ann Plast Surg., 31, pp. 313-317; Demirseren, M.E., Gokrem, S., Ozdemir, O.M., Hatchet-shaped tensor fascia lata musculocutaneous flap for the coverage of trochanteric pressure sores: A new modification (2003) Ann Plast Surg., 51, pp. 419-422; Bovet, J.L., Nassif, T.M., Guimberteau, J.C., The vastus lateralis musculocutaneous flap in the repair of trochanteric pressure sores: Technique and indications (1982) Plast Reconstr Surg., 69, pp. 830-834; Tzeng, Y.S., Yu, C.C., Chou, T.D., Proximal pedicled anterolateral thigh flap for reconstruction of trochanteric defect (2008) Ann Plast Surg., 61, pp. 79-82; Wang, C.H., Chen, S.Y., Fu, J.P., Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps (2011) J Plast Reconstr Aesthet Surg., 64, pp. 671-676; Gravvanis, A.I., Tsoutsos, D.A., Karakitsos, D., Application of the pedicled anterolateral thigh flap to defects from the pelvis to the knee (2006) Microsurgery., 26, pp. 432-438; Paletta, C., Bartell, T., Shehadi, S., Applications of the posterior thigh flap (1993) Ann Plast Surg., 30, pp. 41-47; Little, J.W., Lyons, J.R., The gluteus mediusYtensor fasciae latae flap (1983) Plast Reconstr Surg., 71, pp. 366-371; Meltem, C., Esra, C., Hasan, F., The gluteal perforator-based flap in repair of pressure sores (2004) Br J Plast Surg., 57, pp. 342-347; Geoffrey, G., Halock, G.G., The propeller flap version of the adductor muscle perforator flap for coverage of ischial or trochanteric pressure sores (2006) Ann Plast Surg., 56, pp. 540-542; Aslan, G., Tuncali, D., Bingul, F., The {"}duck{"} modification of the tensor fascia lata flap (2005) Ann Plast Surg., 54, pp. 637-639; J{\'o}svay, J., Sashegyi, M., Kelemen, P., Modified tensor fascia lata musculofasciocutaneous flap for the coverage of trochanteric pressure sores (2006) J Plast Reconstr Aesthet Surg., 59, pp. 137-141; Kuo, Y.R., Jeng, S.F., Kuo, M.H., Free anterolateral thigh flap for extremity reconstruction: Clinical experience and functional assessment of donor site (2001) Plast Reconstr Surg., 107, pp. 1766-1771; Lin, M.T., Chang, K.P., Lin, S.D., Tensor fasciae latae combined with tangentially split vastus lateralis musculocutaneous flap for the reconstruction of pressure sores (2004) Ann Plast Surg., 53, pp. 343-347; Lefemine, V., Enoch, S., Boyce, D.E., Surgical and reconstructive management of pressure ulcers (2009) Eur J Plast Surg., 32, pp. 63-75",
year = "2013",
doi = "10.1097/SAP.0b013e3182586fac",
language = "English",
volume = "71",
pages = "659--663",
journal = "Annals of Plastic Surgery",
issn = "0148-7043",
publisher = "Lippincott Williams and Wilkins",
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}

TY - JOUR

T1 - Comparison of hatchet-shaped tensor fascia lata flap and pedicle anterior lateral thigh flap for treatment of trochanteric sores: A retrospective analysis of 48 patients

AU - Li, Chun-Chang

AU - Chang, Shun-Cheng

AU - Fu, Ju-Peng

AU - Tzeng, Yuan-Sheng

AU - Wang, Chih-Hsin

AU - Chen, Tim-Mo

AU - Chen, Shyi-Gen

N1 - 被引用次數:1 Export Date: 21 March 2016 CODEN: APCSD 通訊地址: Chen, S.-G.; Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Rd, Sec 2, Taipei 114, Taiwan; 電子郵件: shyigen@gmail.com 參考文獻: Nahai, F., Silverton, J.S., Hill, H.L., The tensor fasciae lata musculocutaneous flap (1978) Ann Plast Surg., 1, pp. 372-379; Paletta, C.E., Freedman, B., Shehadi, S.I., The V-Y tensor fasciae latae musculocutaneous flap (1989) Plast Reconstr Surg., 83, pp. 852-857; Erconen, A.R., Apaydin, I., Emiroglu, M., Island V-Y tensor fasciae latae fasciocutaneous flap for the coverage of trochanteric pressure sores (1998) Plast Reconstr Surg., 102, pp. 1524-1531; Siddiqui, A., Wiedrich, T., Lewis, V., Tensor fasciae lata V-Y retroposition myocutaneous flap: Clinical experience (1993) Ann Plast Surg., 31, pp. 313-317; Demirseren, M.E., Gokrem, S., Ozdemir, O.M., Hatchet-shaped tensor fascia lata musculocutaneous flap for the coverage of trochanteric pressure sores: A new modification (2003) Ann Plast Surg., 51, pp. 419-422; Bovet, J.L., Nassif, T.M., Guimberteau, J.C., The vastus lateralis musculocutaneous flap in the repair of trochanteric pressure sores: Technique and indications (1982) Plast Reconstr Surg., 69, pp. 830-834; Tzeng, Y.S., Yu, C.C., Chou, T.D., Proximal pedicled anterolateral thigh flap for reconstruction of trochanteric defect (2008) Ann Plast Surg., 61, pp. 79-82; Wang, C.H., Chen, S.Y., Fu, J.P., Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps (2011) J Plast Reconstr Aesthet Surg., 64, pp. 671-676; Gravvanis, A.I., Tsoutsos, D.A., Karakitsos, D., Application of the pedicled anterolateral thigh flap to defects from the pelvis to the knee (2006) Microsurgery., 26, pp. 432-438; Paletta, C., Bartell, T., Shehadi, S., Applications of the posterior thigh flap (1993) Ann Plast Surg., 30, pp. 41-47; Little, J.W., Lyons, J.R., The gluteus mediusYtensor fasciae latae flap (1983) Plast Reconstr Surg., 71, pp. 366-371; Meltem, C., Esra, C., Hasan, F., The gluteal perforator-based flap in repair of pressure sores (2004) Br J Plast Surg., 57, pp. 342-347; Geoffrey, G., Halock, G.G., The propeller flap version of the adductor muscle perforator flap for coverage of ischial or trochanteric pressure sores (2006) Ann Plast Surg., 56, pp. 540-542; Aslan, G., Tuncali, D., Bingul, F., The "duck" modification of the tensor fascia lata flap (2005) Ann Plast Surg., 54, pp. 637-639; Jósvay, J., Sashegyi, M., Kelemen, P., Modified tensor fascia lata musculofasciocutaneous flap for the coverage of trochanteric pressure sores (2006) J Plast Reconstr Aesthet Surg., 59, pp. 137-141; Kuo, Y.R., Jeng, S.F., Kuo, M.H., Free anterolateral thigh flap for extremity reconstruction: Clinical experience and functional assessment of donor site (2001) Plast Reconstr Surg., 107, pp. 1766-1771; Lin, M.T., Chang, K.P., Lin, S.D., Tensor fasciae latae combined with tangentially split vastus lateralis musculocutaneous flap for the reconstruction of pressure sores (2004) Ann Plast Surg., 53, pp. 343-347; Lefemine, V., Enoch, S., Boyce, D.E., Surgical and reconstructive management of pressure ulcers (2009) Eur J Plast Surg., 32, pp. 63-75

PY - 2013

Y1 - 2013

N2 - PURPOSE: Surgical reconstruction of trochanteric sores remains a formidable task for plastic surgeons. Diverse types of flaps have been proposed for use in this situation, each with particular advantages and limitations. This study aimed to compare the surgical outcomes between the hatchet-shaped tensor fascia lata (TFL) flap and the pedicle anterior lateral thigh (ALT) flap in treatment of trochanteric sores. METHODS: Forty-eight patients with trochanteric sores were operated on under spinal or general anesthesia using TFL or ALT flaps between August 2007 and November 2010. In the TFL group, 26 hatchet-shaped TFL musculocutaneous flaps were performed on 24 patients. In the ALT group, 25 pedicle ALT musculocutaneous flaps were performed on 24 patients. Surgical outcomes were retrospectively analyzed. RESULTS: No significant difference was detected between the TFL and ALT groups in terms of age, preoperative disease period, obesity (body mass index), American Society of Anesthesiologists score, comorbidity, the defect size, follow-up time, and complication rate. The recurrence rate and the flap size were significantly higher in the TFL group than in the ALT group (P = 0.022; P <0.001). The operation time was longer in the ALT group (P <0.001). CONCLUSIONS: The pedicle ALT flap is a more effective treatment than the TFL flap for the surgical management of trochanteric sores. The hatchet-shaped TFL flap should be reserved for the reconstruction of recurrent trochanteric sores or for use in the critically ill patient who cannot tolerate longer anesthesia and operation time. © 2013 by Lippincott Williams & Wilkins.

AB - PURPOSE: Surgical reconstruction of trochanteric sores remains a formidable task for plastic surgeons. Diverse types of flaps have been proposed for use in this situation, each with particular advantages and limitations. This study aimed to compare the surgical outcomes between the hatchet-shaped tensor fascia lata (TFL) flap and the pedicle anterior lateral thigh (ALT) flap in treatment of trochanteric sores. METHODS: Forty-eight patients with trochanteric sores were operated on under spinal or general anesthesia using TFL or ALT flaps between August 2007 and November 2010. In the TFL group, 26 hatchet-shaped TFL musculocutaneous flaps were performed on 24 patients. In the ALT group, 25 pedicle ALT musculocutaneous flaps were performed on 24 patients. Surgical outcomes were retrospectively analyzed. RESULTS: No significant difference was detected between the TFL and ALT groups in terms of age, preoperative disease period, obesity (body mass index), American Society of Anesthesiologists score, comorbidity, the defect size, follow-up time, and complication rate. The recurrence rate and the flap size were significantly higher in the TFL group than in the ALT group (P = 0.022; P <0.001). The operation time was longer in the ALT group (P <0.001). CONCLUSIONS: The pedicle ALT flap is a more effective treatment than the TFL flap for the surgical management of trochanteric sores. The hatchet-shaped TFL flap should be reserved for the reconstruction of recurrent trochanteric sores or for use in the critically ill patient who cannot tolerate longer anesthesia and operation time. © 2013 by Lippincott Williams & Wilkins.

KW - anterior lateral thigh flap

KW - pressure sore

KW - tensor fascia lata flap

KW - trochanteric sore

KW - adult

KW - aged

KW - article

KW - case report

KW - comparative study

KW - decubitus

KW - evaluation study

KW - fascia lata

KW - female

KW - femur

KW - follow up

KW - human

KW - male

KW - methodology

KW - middle aged

KW - myocutaneous flap

KW - plastic surgery

KW - retrospective study

KW - thigh

KW - treatment outcome

KW - very elderly

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Fascia Lata

KW - Female

KW - Femur

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocutaneous Flap

KW - Pressure Ulcer

KW - Reconstructive Surgical Procedures

KW - Retrospective Studies

KW - Thigh

KW - Treatment Outcome

U2 - 10.1097/SAP.0b013e3182586fac

DO - 10.1097/SAP.0b013e3182586fac

M3 - Article

VL - 71

SP - 659

EP - 663

JO - Annals of Plastic Surgery

JF - Annals of Plastic Surgery

SN - 0148-7043

IS - 6

ER -