Newly-Designed Inferior Gluteus Maximus Myocutaneous Island Flap for Treatment of Ischial Sore.

Park, Bong Kweon; Ahn, Hee Chang

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(5):984-990.
Published online September 1, 1999.

Newly-Designed Inferior Gluteus Maximus Myocutaneous Island Flap for Treatment of Ischial Sore.

Bong Kweon Park, Hee Chang Ahn

Abstract

The area overlying the ischium is the most frequent site for the development and recurrence of pressure sores in the paraplegic patient. This report describes a newly-designed inferior gluteus maximus myocutaneous island flap that is useful for the repair of ischial pressure sores in paraplegic patients. Sacral sore develops a wide and flat ulcer crater. However, ischial sore seems to develop large and deep bursa with relatively small openings. We have used a newly-designed gluteus maximus myocutaneous island flap according to the specific characteristics of ischial sore. The flap is designed in the fashion of a small skin island with a large muscle flap. This flap with its abundant and constant blood supply had proved very reliable in the surgical management of ischial pressure sore. There is also the possible advantage of cushioning with the bulk of muscle for greater long-term durability. Incision could be extended for a complete bursetomy and partial ischiectomy. The reliability, versatility and low morbidity of the inferior gluteus maximus island flap has been demonstrated by its use in our consecutive series of 7 patients with 8 ischial pressure sores. We conclude that this newly-designed inferior gluteus maximus myocutaneous island flap can be applied in deep, infected ischial sore according to the specific characteristics of ischial sore, and it is a very useful method in comparison to other flaps.