LOCAL FLAP TECHNIQUES OUTCOME FOR SACRAL PRESSURE ULCERS CLOSURES: A SYSTEMATIC REVIEW
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Highlights:
- Local flap reconstruction for sacral defects due to chronic pressure ulcers faces major challenges, including a high risk of infection, recurrence, and the complex sacral anatomy.
- Effective local flap techniques tailored to patient needs such as, the Clover Style, Modified Parasacral Bilobed, and Bilobed Flaps have been shown to improve both functional and aesthetic outcomes.
Abstract:
Introduction: Sacral pressure ulcers (PUs) pose a major challenge, especially in bedridden and elderly patients, due to risks like infection and delayed healing. Surgical reconstruction using local flaps offers effective defect closure with low donor-site complications. This systematic review analyzes local flap techniques for sacral PU reconstruction based on studies published from 2019 to 2024.
Method: A comprehensive literature search was conducted in PubMed, selecting empirical studies that met predefined inclusion criteria. A total of seven studies were reviewed, comprising five case series and two case reports.
Result: The findings highlight multiple local flap techniques, including the Clover-Style Fasciocutaneous Perforator Flap, Modified Parasacral Perforator-Based Bilobed Flap, and Bilobed Flap, each demonstrating favorable outcomes with high flap survival rates and minimal complications. These techniques offer advantages such as tension-free closure, enhanced vascularity, and reduced recurrence risk, making them viable alternatives for sacral PU management.
Conclusion: Local flap reconstruction is a reliable and effective method for managing sacral pressure ulcers, with high success rates and good healing outcomes. Flap selection depends on defect size, patient condition, and surgeon expertise. A multidisciplinary approach involving preoperative imaging, wound care specialists, and physiotherapists can enhance surgical success. Further research, particularly randomized controlled trials, is needed to strengthen evidence-based flap selection criteria. Overall, local flaps remain the mainstay in sacral pressure ulcer reconstruction, contributing to improved patient quality of life.
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