Reconstruction of Multiple Location Bedsores

https://doi.org/10.25143/rsu-bjcmr.2024.01.009-015

Abstract

Keywords: Fillet flaps, Pressure sores, Reconstructive surgery, Spinal trauma

Introduction: Regress of a patient’s functional integrity due to spinal trauma is often complicated by the development of multiple bedsores. Reconstructive autograft surgery is used to maximise physiological and functional well-being.

Case description: A patient has a history of a spinal trauma suffered in 2018 with a lower paresis, leading to the development of bedsores – in the sacrum area, the greater trochanter area, the ischial tuberosity area. The patient was initially subjected to debridement and subsequently the formation of a lower extremity flap of the right leg was carried out. On 11.02.2021 a flap was prepared to the plantar surface of the right foot to the hip joint for a wide soft tissue flap on the front surface. The soft tissue was separated from the bone architecture, as well as the patella resection and tibia exarticulation in the knee, hip joint arthrotomy and femur exarticulation from acetabulum were carried out. After repeated debridement of ulcers, the flap is folded from the front surface of the right side across the right trochanter area, the sacrum area towards the left pelvis. The shape of the flap is created by adjusting it to the bedsored areas. At the end, flap fixing, drain insertion, application of aseptic bandage were carried out. Due to the dehiscence of perianal wounds caused by faecal contamination, a sigmostoma was formed on 04.03.2021.

Summary: A fillet flap creation with the right leg exarticulation was a reconstructive manipulation to improve the quality of life and health of the patient.

Conclusions: Late results reveal a successful scarring process. The patient is able to perform a lot of daily routines.