Outcome of V-Y Tensor Fascia Lata (TFL) Musculocutaneous Flap in the Treatment of Trochanteric Pressure Sores

Background: Trochanteric ulcers appear under direct pressure from the greater trochanter and are consistently initiate in patients lying in lateral decubitus position for long duration. Stage-III & IVtrochanteric pressure
ulcers needs surgical intervention specially needs flap coverage. V-Y advancement flaps is a reliable technique,

Objectives: To evaluatethe outcome of surgical closure of trochanteric pressure ulcers by V-Y tensor fascia lata musculocutaneous flap.

Methods: This prospective observational study was carried out at the Department of Surgery and Department of Burn & Plastic Surgery, Sylhet MAG Osmani Medical College Hospital from 17th June 2019 to 16th June 2020. A total of twenty patients with stage-III or stage-IV trochanteric pressure ulcers were included in this study.

Result: Among the patients with trochanteric pressure ulcers 12(60%) were in stage III and 8(40.0%) were in stage IV. In all patients surgery was done under spinal anesthesia and primary closure was considered for donor site closure. Mean length of the ulcer was (9.5±1.5) cm and mean width was (8.0±2.9) cm after wound excision. All the defects were covered adequately by the flap. The mean length of flap size needed was (18.2±4.7) cm and mean width of the flap needed was (9.0±3.4) cm. It was evident that, 16 (80.0%) flaps were viable and 4 (20.0%) had marginal necrosis.

Conclusion: V-Y tensor fascia lata is an effective, reliable surgical technique for stage-III or stage-IV trochanteric pressure ulcers management.