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CC BY-NC 4.0 · Arch Plast Surg 2016; 43(06): 586-589
DOI: 10.5999/aps.2016.43.6.586
Case Report

Multidisciplinary Approach to an Extended Pressure Sore at the Lumbosacral Area

Sehoon Yoon
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
,
Euicheol Jeong
Department of Plastic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea
,
Hudson Alex Lázaro
Dr. Hudson Lázaro, Cirurgia Plástica Transplante Capilar, Pará de Minas, Brazil
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A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible. The large soft tissue defect with significant depth was reconstructed with a free latissimus dorsi musculocutaneous flap, which was expected to act as a local barrier from vertical infection and provide tensionless skin coverage upon hip flexion. The extensive sacral sore was treated effectively without complication, and the deep tissue infection completely resolved. There was no evidence of donor site morbidity, and wheelchair ambulation was possible by a month after surgery.

Keywords

Pressure ulcer - Osteomyelitis - Epidural abcess - Psoas abscess


Publication History

Received: 15 April 2016

Accepted: 28 September 2016

Article published online:
20 April 2022

© 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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