Alexandre Almeida1,2* and F. Martins de Carvalho1,2
Background: Reconstruction of pressure sores still present a major challenge in plastic surgery due to high rates of wound dehiscence and pressure sore recurrence. Trochanteric sores are generally closed with tensor fascia lata flaps, however with high recurrence rates.
Case report: We illustrated a case of trochanteric pressure sore with osteomyelitis of the femoral head treated with an alternative reconstructive option, Girdlestone procedure and a pedicled anterolateral thigh myocutaneous flap. Wide debridement of infected tissues and filling of dead space are of paramount importance in the treatment of pressure sores. In the presented case, with a one-stage surgery and prolonged antibiotherapy, the infection was resolved, and the postoperative period was uneventful. We were able to reconstruct the pressure sore with well vascularized tissue, without tension and padded by the vastus lateralis muscle cuff included. Also, the aesthetic result was superior to the tensor fascia lata flap, without dog ear deformity and no donor site skin grafting.
Conclusion: The Girdlestone procedure with an ALT myocutaneous flap is a good reconstructive option for trochanteric pressure sores.
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