Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores

Chin-Ta Lin, Shih-Yi Chen, Shyi-Gen Chen, Yuan-Sheng Tzeng, Shun-Cheng Chang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Methods: Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. Results: There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Conclusions: Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Original languageEnglish
Pages (from-to)62-65
Number of pages4
JournalAnnals of Plastic Surgery
Volume75
Issue number1
DOIs
Publication statusPublished - 2015
Externally publishedYes

Fingerprint

Perforator Flap
Pressure Ulcer
Length of Stay
Reconstructive Surgical Procedures
Tissue Donors
Pilonidal Sinus
Muscles
Methicillin-Resistant Staphylococcus aureus
Survival Rate
Arteries
Morbidity
Recurrence

Keywords

  • parasacral perforator flap
  • reconstruction
  • sacral sore

Cite this

Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores. / Lin, Chin-Ta; Chen, Shih-Yi; Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Chang, Shun-Cheng.

In: Annals of Plastic Surgery, Vol. 75, No. 1, 2015, p. 62-65.

Research output: Contribution to journalArticle

Lin, Chin-Ta ; Chen, Shih-Yi ; Chen, Shyi-Gen ; Tzeng, Yuan-Sheng ; Chang, Shun-Cheng. / Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores. In: Annals of Plastic Surgery. 2015 ; Vol. 75, No. 1. pp. 62-65.
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title = "Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores",
abstract = "Background: Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Methods: Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. Results: There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95{\%} (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Conclusions: Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects. Copyright {\circledC} 2015 Wolters Kluwer Health, Inc. All rights reserved.",
keywords = "parasacral perforator flap, reconstruction, sacral sore",
author = "Chin-Ta Lin and Shih-Yi Chen and Shyi-Gen Chen and Yuan-Sheng Tzeng and Shun-Cheng Chang",
note = "Export Date: 21 March 2016 CODEN: APCSD 通訊地址: Chang, S.-C.; Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, No. 325, Section 2, Cheng-Gung Rd, Taiwan 參考文獻: Minami, R.T., Mills, R., Pardoe, R., Gluteus maximus myocutaneous flaps for repair of pressure sores (1977) Plast Reconstr Surg, 60, pp. 242-249; Parry, S.W., Mathes, S.J., Bilateral gluteus maximus myocutaneous advancement flaps: Sacral coverage for ambulatory patients (1982) Ann Plast Surg, 8, pp. 443-445; Stevenson, T.R., Pollock, R.A., Rohrich, R.J., The gluteus maximus musculocutaneous island flap: Refinements in design and application (1987) Plast Reconstr Surg, 79, pp. 761-768; Koshima, I., Moriguchi, T., Soeda, S., The gluteal perforator-based flap for repair of sacral pressure sores (1993) Plast Reconstr Surg, 91, pp. 678-683; Verpaele, A.M., Blondeel, P.N., Van Landuyt, K., The superior gluteal artery perforator flap: An additional tool in the treatment of sacral pressure sores (1999) Br J Plast Surg, 52, pp. 385-391; Kierney, P.C., Engrav, L.H., Isik, F.F., Results of 268 pressure sores in 158 patients managed jointly by plastic surgery and rehabilitation medicine (1998) Plast Reconstr Surg, 102, pp. 765-772; Acarturk, T.O., Parsak, C.K., Sakman, G., Superior gluteal artery perforator flap in the reconstruction of pilonidal sinus (2010) J Plast Reconstr Aesthet Surg, 63, pp. 133-139; Roche, N.A., Van Landuyt, K., Blondeel, P.N., The use of pedicled perforator flaps for reconstruction of lumbosacral defects (2000) Ann Plast Surg, 45, pp. 7-14; 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; Ahmadzadeh, R., Bergeron, L., Tang, M., The superior and inferior gluteal artery perforator flaps (2007) Plast Reconstr Surg, 120, pp. 1551-1556; Coskunfirat, O.K., Ozgentas, H.E., Gluteal perforator flaps for coverage of pressure sores at various locations (2004) Plast Reconstr Surg, 113, pp. 2012-2017. , discussion 2018-9; Lee, J.T., Hsiao, H.T., Tung, K.Y., Gluteal perforator flaps for coverage of pressure sores at various locations (2006) Plast Reconstr Surg, 117, pp. 2507-2508; Demir, A., Acar, M., Yldz, L., The effect of twisting on perforator flap viability: An experimental study in rats (2006) Ann Plast Surg, 56, pp. 186-189",
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TY - JOUR

T1 - Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores

AU - Lin, Chin-Ta

AU - Chen, Shih-Yi

AU - Chen, Shyi-Gen

AU - Tzeng, Yuan-Sheng

AU - Chang, Shun-Cheng

N1 - Export Date: 21 March 2016 CODEN: APCSD 通訊地址: Chang, S.-C.; Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, No. 325, Section 2, Cheng-Gung Rd, Taiwan 參考文獻: Minami, R.T., Mills, R., Pardoe, R., Gluteus maximus myocutaneous flaps for repair of pressure sores (1977) Plast Reconstr Surg, 60, pp. 242-249; Parry, S.W., Mathes, S.J., Bilateral gluteus maximus myocutaneous advancement flaps: Sacral coverage for ambulatory patients (1982) Ann Plast Surg, 8, pp. 443-445; Stevenson, T.R., Pollock, R.A., Rohrich, R.J., The gluteus maximus musculocutaneous island flap: Refinements in design and application (1987) Plast Reconstr Surg, 79, pp. 761-768; Koshima, I., Moriguchi, T., Soeda, S., The gluteal perforator-based flap for repair of sacral pressure sores (1993) Plast Reconstr Surg, 91, pp. 678-683; Verpaele, A.M., Blondeel, P.N., Van Landuyt, K., The superior gluteal artery perforator flap: An additional tool in the treatment of sacral pressure sores (1999) Br J Plast Surg, 52, pp. 385-391; Kierney, P.C., Engrav, L.H., Isik, F.F., Results of 268 pressure sores in 158 patients managed jointly by plastic surgery and rehabilitation medicine (1998) Plast Reconstr Surg, 102, pp. 765-772; Acarturk, T.O., Parsak, C.K., Sakman, G., Superior gluteal artery perforator flap in the reconstruction of pilonidal sinus (2010) J Plast Reconstr Aesthet Surg, 63, pp. 133-139; Roche, N.A., Van Landuyt, K., Blondeel, P.N., The use of pedicled perforator flaps for reconstruction of lumbosacral defects (2000) Ann Plast Surg, 45, pp. 7-14; 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; Ahmadzadeh, R., Bergeron, L., Tang, M., The superior and inferior gluteal artery perforator flaps (2007) Plast Reconstr Surg, 120, pp. 1551-1556; Coskunfirat, O.K., Ozgentas, H.E., Gluteal perforator flaps for coverage of pressure sores at various locations (2004) Plast Reconstr Surg, 113, pp. 2012-2017. , discussion 2018-9; Lee, J.T., Hsiao, H.T., Tung, K.Y., Gluteal perforator flaps for coverage of pressure sores at various locations (2006) Plast Reconstr Surg, 117, pp. 2507-2508; Demir, A., Acar, M., Yldz, L., The effect of twisting on perforator flap viability: An experimental study in rats (2006) Ann Plast Surg, 56, pp. 186-189

PY - 2015

Y1 - 2015

N2 - Background: Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Methods: Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. Results: There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Conclusions: Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

AB - Background: Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Methods: Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. Results: There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Conclusions: Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

KW - parasacral perforator flap

KW - reconstruction

KW - sacral sore

U2 - 10.1097/SAP.0000000000000024

DO - 10.1097/SAP.0000000000000024

M3 - Article

VL - 75

SP - 62

EP - 65

JO - Annals of Plastic Surgery

JF - Annals of Plastic Surgery

SN - 0148-7043

IS - 1

ER -