Reconstructive procedure for treatment of trochanteric pressure ulcers in spinal-cord-injured patients

Background Pressure ulcers are frequent complications for spinal-cord-injured patients and, trochanteric pressure sores, are quite difficult to treat. This site requires to consider some aspects, such as wound dimension, surgical timing, and reconstructive flap choice. Methods We report our experience from 2011 to 2016 on 82 trochanteric sores in 68 spinal-cord-injured patients. All the cases were treated with two-time procedures. Firstly, we performed the surgical toilette of the wound, and in the second procedure, the reconstruction with a muscle or musculocutaneous flap. Results Using the two-time procedure, we report no recurrences after a mean follow-up of 3 years. The main complication reported was a seroma that undergo to a spontaneous resolution. Conclusions Conclusions We believe that the described approach can be useful to treat trochanteric sores and to reduce the recurrence rate. Muscle flaps seem to be superior to fasciocutaneous or perforator flaps in this site. Level of evidence: Level III, therapeutic study.