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J Reconstr Microsurg 2002; 18(5): 397-400
DOI: 10.1055/s-2002-33023
DOI: 10.1055/s-2002-33023
Reinnervated Medial Gastrocnemius Free Flap for Closure of a Recurrent Ischial Pressure Sore: Case Report
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Publikationsverlauf
Publikationsdatum:
31. Juli 2002 (online)
ABSTRACT
A 42-year-old T7 level paraplegic man had undergone multiple local flap transfers for closure of a recurrent left ischial pressure sore. When wound breakdown again occurred and regional flap transfers were no longer a possibility, a medial gastrocnemius free flap was transferred to the ischial region. Reinnervation of this flap was accomplished by interposing a sural nerve graft between a proximal intercostal nerve and the tibial motor nerve branch of the gastrocnemius muscle. Following the return of protective sensation, the patient has developed no new ischial pressure ulcerations.
KEYWORDS
Ischial pressure sore - gastrocnemius free flap - nerve graft
REFERENCES
- 1 Landis E M. Micro-injection studies of capillary blood pressure in human skin. Heart . 1930; 15 209-228
- 2 Kosiak M. Etiology and pathology of ischemic ulcers. Arch Phys Med Rehab . 1959; 40 62-69
- 3 Mathes S J, Nahai F. Clinical Applications for Muscle and Myocutaneous Flaps. St. Louis: C.V. Mosby 1982
- 4 Penna M M, Drew G S, Smith S J, Given K S. The inferiorly based rectus abdominis myocutaneous flap for reconstruction of recurrent pressure sores. Plast Reconst Surg . 1992; 92 90-5
- 5 Royer J, Pickrell K, Georgiade N. Total thigh flaps for extensive decubitus ulcers. A 16 year review of 41 total thigh flaps. Plast Reconstr Surg . 1969; 44 109-118
- 6 Dibbel D G. Use of a long island flap to bring sensation to the sacral area in young paraplegics. Plast Reconstr Surg . 1974; 54 220-223
- 7 Daniel R K, Terzis J K, Cunningham D M. Sensory skin flaps for coverage of pressure sores in paraplegic patients. Plast Reconst Surg . 1976; 58 317-328
- 8 Goldberg J A, Barwick W J, Levin L S. Restoration of sensation in paraplegia by a sensory innervated plantar fillet free flap: case report. Paraplegia . 1995; 33 116-119
- 9 Kuntscher M V, Blome-Eberwein S, Peltzer M, et. al. The concept of fillet flaps: classification, indications, and analysis of their clinical value. Plast Reconstr Surg . 2001; 4 885-896
- 10 Keller A, Allen R, Shaw W. The medial gastrocnemius muscle flap: a local free flap. Plast Reconstr Surg . 1984; 73 302-307
- 11 Potparic Z, Colen L B, Sucur D, Carwell G R. The gastrocnemius muscle as a free-flap donor site. Plast Reconstr Surg . 1995; 95 1245-1252
- 12 Hallock G G. Closure of an ischial pressure sore using a free gastrocnemius musculocutaneous flap with a long venous pedicle. Br J Plast Surg . 1995; 48 504-506
- 13 Chang K N, DeArmond S J, Buncke H J. Sensory reinnervation in microsurgical reconstruction of the heel. Plast Reconstr Surg . 1986; 78 652-663