Abstract

REVELO JIRON, E.. Importance of volume and gluteal fold reconstruction in paraplegic patients with ischial ulcers type Enis Sarmiento IV. Cir. plást. iberolatinoam. [online]. 2011, vol.37, n.2, pp.147-153. ISSN 1989-2055.  https://dx.doi.org/10.4321/S0376-78922011000200007.

Paraplegic patients, during their rehabilitation period, usually develop ischial ulcers as the most common complication. When there is bone involvement only the surgical approach can be successful. Myocutaneous flaps are part of this approach. We present a sample of 10 paraplegic patients under rehabilitation suffering ischial ulcers that were handled with myocutaneous island flaps obtained from the lower bundles of gluteus maximus and transferred though a subcutaneous tunnel. All these patients have had a long term good evolution with no recurrences. We would like to emphasize that the basic principles of Aesthetic Surgery should be followed: incisions should follow natural creases to avoid aesthetic and functional sequels; leave minimal scar and attain restoration of body volume. We feel that the design of flaps must follow faithfully the gluteal fold orientation and should provide a good mattress to build a good volume on the gluteal area. It is fundamental to leave minimal scarring to avoid the risks of local damages due to the omnipresent degree of atrophy of the skin; thus preventing recurrences and complications.

Keywords : Ischial ulcer; Paraplegic; Gluteal fold; Miocutaneous flaps.

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