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CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2021; 06(01): e35-e39
DOI: 10.1055/s-0041-1729640
Original Article

Free Tissue Transfer in Pressure Ulcer Reconstruction: A Systematic Review

Chelsi Robertson
1   School of Medicine, Louisiana State University, New Orleans, Louisiana
,
Charles Patterson
2   Department of Surgery, Section of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center; New Orleans, Louisiana
,
Hugo St. Hilaire
2   Department of Surgery, Section of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center; New Orleans, Louisiana
,
Frank H. Lau
2   Department of Surgery, Section of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center; New Orleans, Louisiana
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Abstract

Background Pressure ulcers (PUs) affect 2.5 million people in the United States annually and incur health-care costs of 11 billion dollars annually. Stage III/IV PU often require local flap reconstruction. Unfortunately, PU recurrence is common following reconstruction; recurrence rates as high as 82% have been reported. When local flap options are inadequate, free tissue transfer may be indicated but the indications have yet to be delineated. To develop evidence-based guidelines for the use of free flaps in PU reconstruction, we performed a systematic review.

Methods A systematic review of the available English-language, peer-reviewed literature was conducted using PubMed/MEDLINE, Google Scholar, Scopus, EMBASE, and the Cochrane Database of Systematic Reviews. Articles were manually reviewed for relevance.

Results Out of 272 articles identified, 10 articles were included in the final analysis. Overall, this systematic review suggests that free-flap PU reconstruction yields fewer recurrences compared with local flaps (0–20 vs. 13–82%). Further, several types of free flaps for PU reconstruction were identified in this review, along with their indications.

Conclusion Free tissue transfer should be considered for recurrent PU. We offer specific recommendations for their use in PU reconstruction.

Keywords

pressure ulcers - pressure sores - free flaps - free tissue transfer - recurrence

Financial Disclosure Statement

No funding was received for this article.




Publication History

Received: 19 October 2020

Accepted: 15 February 2021

Article published online:
28 June 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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