Expanded flaps in surgical treatment of pressure sores: Our experience for 25 years

Giovanni Di Caprio, José Maria Serra-Mestre, Pasquale Ziccardi, Michelina Scioli, Fabio Larocca, Vincenzo Nunziata, Roberto Grella, Francesco D'Andrea

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Because the ischial region is the main weight-bearing area in sitting, it is one of the areas most frequently affected by pressure ulcers in paraplegic patients resuming the sitting position during the subacute and chronic stages. The techniques described to date have not been able to reduce the high rates of recurrence and flap dehiscence. Other groups have described successful tissue expansion in the treatment of pressure ulcers, but to date, the long-term results of the procedure have not been reported. METHODS: The long-term follow-up of 138 reconstructions of the ischial region in patients with pressure ulcers types III to IV treated with posterior thigh expanded rotation flaps is reported. RESULTS: All patients achieved complete resolution, with adequate coverage of deeper layers, although 15.94% presented minor complications. None of these complications impeded full repair of the lesion. The 28 lesions that recurred were all reconstructed with the re-expansion of the same flap. There were no cases of flap dehiscence. CONCLUSIONS: The use of tissue expanders to treat ischial pressure ulcers, especially in patients with long life expectancy, offers important advantages over other approaches. The procedure provides abundant, high-quality tissue and may be repeated many times without creating new scars. With the use of tissue expanders, other reconstructive options can be reserved for the future.

Original languageEnglish
JournalAnnals of Plastic Surgery
Publication statusAccepted/In press - Aug 28 2014

ASJC Scopus subject areas

  • Surgery


Dive into the research topics of 'Expanded flaps in surgical treatment of pressure sores: Our experience for 25 years'. Together they form a unique fingerprint.

Cite this