Category Archives: Massive ulcers

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: RESULTS (part 2)

On the other hand, seven of the eight male patients had a remarkably similar past social history of ongoing behavioural, financial and social problems since their initial injury. Review of previous evaluations by social workers and psychiatrists identified that these … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: DISCUSSION (part 3)

Royer et al stated that, at follow-up, eight of 17 living patients and nine of 11 deceased patients (total 17 of 28 [61%]) had recurrent pressure sores. In a more recent review of efficacy of operative cure in pressure sore … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: DISCUSSION (part 2)

Our indication to use the total thigh flap was as a salvage procedure to obtain coverage of massive or multiple ulcers of the buttocks no longer amenable to local or regional tissue coverage. This indication agrees with the indications listed … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: DISCUSSION (part 1)

The management of multiple, or massive, pressure sores in spinal cord injured patients can be a very difficult problem. Fortunately, the number of patients that actually get to this point is quite small. Royer et al reported their experience with … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: RESULTS (part 7)

Despite all seven patients being relatively satisfied with the outcome of this major operation, all seven patients developed new pressure sores, as early as three months postoperatively. Three patients developed sores on the side opposite the amputation, two patients on … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: RESULTS (part 6)

Follow-up Of the eight surviving patients, seven survived longer than one year postoperatively and were available for follow-up (mean 3.5 years postoperatively, range 1.3 to 6 years). All seven patients left the hospital with healed flaps and returned to independent … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: RESULTS (part 5)

Operative results The procedure was long (mean 6.2 h; range 3.5 to 8.5 h) and associated with a great deal of blood loss, estimated at 3000 to 5000 mL/case. The mean amount of blood transfused throughout the hospital stay (including … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: RESULTS (part 4)

Total thigh flap-technique The operation performed was similar to previously described techniques with certain modifications. Patients were placed in the prone position. Debridement of the entire ulcerated area was again performed. The incision was marked on the midlateral aspect of … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: RESULTS (part 3)

Adjunctive procedures included colostomy (n=3), suprapubic catheter insertion (n=2), and broviac catheter insertion (n=2). In five of 10 cases, a girdlestone arthroplasty (resection of femoral head and neck) was performed by an orthopedic surgeon during the debridement procedure, as an … Continue reading

Total thigh flaps as a salvage procedure in paraplegics with massive ulcers: RESULTS (part 1)

Patient demographics and past history Of the nine patients involved, eight were males and one was female; the mean age was 47.8 years (range 28 to 78 years) at the time of the total thigh flap procedure. Five patients were … Continue reading