Recurrence of pressure sores remains a major challenge in surgical treatment. Recently the perforator flap has proven to be effective in the reconstruction of pressure sores in a variety of regions.
We describe our experience using the proximal pedicled anterolateral thigh (ALT) flap in the treatment of trochanteric pressure sores.
In this study, five ALT flap procedures were performed in 4 patients who had trochanteric pressure sores (NPUAP classification grade IV). They were 2 females and 2 males, and averaged 74.3 years old. In these patients, after the sores were debrided, pedicled ALT flaps were transferred to defects in trochanteric regions. After the operations, all of the flaps survived, with primary closure of the donor site. One flap had a superficial peripheral erosion that was treated conservatively. At the final follow up, there was no recurrence of pressure ulcers.
Trochanteric coverage with the proximal pedicled ALT flap gave excellent results. The ALT flap has the following advantages: 1) reliability because of the pedicled flap, 2) good matching of thickness and skin texture, 3) less damage comparative to muscle flap, 4) primary closure of the donor site, and 5) simultaneous operations of debridement and flap elevation. We conclude that the ALT flap is a reliable alternative flap for trochanteric coverage.