Comparative study of gluteal faciocutaneous rotational flaps and myocutaneous flap for treatment of sacral pressure ulcer-  A cross-sectional study.

Soni  Kumari; Akhil  Unnikrishnan; Anant  Parashar; S.K. Gupta

doi:10.51168/sjhrafrica.v6i6.1894

Authors

Soni Kumari Mch Resident, Department of Plastic Surgery, Patna Medical College Hospital, Patna, Bihar, India
Akhil Unnikrishnan Mch Resident, Department of Plastic Surgery, Patna Medical College Hospital, Patna, Bihar, India,
Anant Parashar Mch Resident, Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar
S.K. Gupta Assistant Professor, Department of Plastic and Reconstructive Surgery, Patna Medical College Hospital, Patna, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1894

Keywords:

Sacral pressure ulcers, gluteal fasciocutaneous flap, myocutaneous flap, surgical reconstruction, recurrence, wound healing

Abstract

Background

Pressure ulcers, particularly sacral ulcers, are a major problem in immobilized patients, requiring effective surgical reconstruction. Gluteal fasciocutaneous (FC) and myocutaneous (MC) flaps are widely used but differ in complexity, durability, and complication rates. This study compares the outcomes of both techniques to guide surgical decision-making.

Methods

A prospective cohort study was carried out from March 2023 to October 2024 at the Department of Plastic and Reconstructive Surgery, Patna. Thirty-nine patients with Stage III/IV sacral pressure ulcers were included and divided into two groups (FC = 18; MC = 21). Preoperative assessment, standardized surgical techniques, and postoperative care were applied. Operative time, healing duration, blood loss, complications, and recurrence.

Results

The mean age was slightly higher in the fasciocutaneous flap group (57.16 ± 12.14 years) compared to the myocutaneous flap group (53.71 ± 14.38 years), though not significant (p = 0.594). The distribution of patients aged ≥61 years was identical in both groups (55.6%). Operative time and healing duration were similar, but blood loss was significantly lower in the FC group (p = 0.001). The MC group had zero recurrence with a short follow of 6 months, while FC showed a 23.5% recurrence rate (p = 0.036). Postoperative complications were minimal and statistically nonsignificant across groups.

Conclusion

This prospective cohort study demonstrated that both gluteal fasciocutaneous and myocutaneous flaps are viable options for the surgical management of sacral pressure ulcers, offering comparable safety and healing outcomes. Myocutaneous flaps demonstrated superior long-term durability, while fasciocutaneous flaps offered lower blood loss and ease of reuse.

Recommendations

As this was a short-term study, further research is needed with a longitudinal study design and a larger sample to achieve more definitive results.

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