Posterior Thigh Flap for Pressure Sores

Abstract

Management of pressure ulcers requires a multifaceted approach for both prevention and treatment. The posterior thigh flap is one option for definitive surgical management. Treatment is initiated optimizing factors for wound healing and minimizing risk factors for recurrence. Obtaining adequate pressure offloading, moisture control, decreased wound contamination, and correction of any malnutrition should be addressed before considering surgery. The arc of rotation allows for potential closure of defects of the upper gluteal region, lower sacrum, greater trochanter, pubis, or perineum. Ischial ulcers treated with the posterior thigh flap can have a high rate of wound healing complications, but total flap loss and other serious complications are relatively rare. Partial loss or recurrence can often be treated with flap readvancement. Patient selection and preparation are keys to success.