Clinical experience with the hatchet-shaped gluteus maximus musculocutaneous flap.

One of the most frequently used flaps for the coverage of sacral skin and soft-tissue defects (primarily decubiti) is the gluteus maximus musculocutaneous flap. The authors have developed a new, hatchet-shaped incision direction for the flap and have been using it for 6 years in the surgical treatment of various pelvic-area defects with good results. At the beginning, the gluteus maximus hatchet-shaped flap was used for treatment of pressure sores in the pelvic area: sacral decubitus on 31 patients, ischial pressure ulcer on 12 patients, and trochanteric ulcer on 1 patient.

[Surgical treatment of decubitus ulcers of the pelvic area in patients with spinal cord injury].

Pressure sores in spinal cord-injured patients can be treated by either conservative or surgical methods. Shortened healing period and long lasting results can be achieved by surgery. Between 1993 and 2001 the authors performed 64 operations with musculocutaneous or musculo-fasciocutaneous flaps in all cases.

[15 years experience in the surgical treatment of decubitus ulcers of the pelvic region].

We summarize our 15 year experience in the surgical treatment of pressure ulcers of the pelvic region. The technique of suggested operations is described (sacral defect--gluteus maximus musculocutaneous V-Y advancement flap, trochanteric defect--tensor fascia lata musculofasciocutaneous transpositional flap, ischial defect--biceps femoris musculocutaneous V-Y advancement flap). In recent years we cover defects in all these regions using the principle of Emmett's hatchet flap--i.