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 journalArticle


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 f lap. There were no cases of f lap 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
Pages (from-to)552-555
Number of pages4
JournalAnnals of Plastic Surgery
Issue number5
Publication statusPublished - 2015


  • Expanded flap
  • Paraplegia
  • Pressure sore
  • Pressure ulcer
  • Spinal cord injury
  • Tissue expansion

ASJC Scopus subject areas

  • Surgery

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    Di Caprio, G., Serra-Mestre, J. M., Ziccardi, P., Scioli, M., Larocca, F., Nunziata, V., Grella, R., & D'Andrea, F. (2015). Expanded flaps in surgical treatment of pressure sores our experience for 25 years. Annals of Plastic Surgery, 75(5), 552-555. https://doi.org/10.1097/SAP.0000000000000199