Clinical experience of a Hemipelvectomy in the End-Stage of the Pressure Sore

Journal of the Korean Society for Surgery of the Hand 2002;11(1):47-52.
Published online May 31, 2002.

Sung-Su Lee, M.D., Jong-Won Hong, M.D., Yoon-Kyu Chung, M.D., Jin-Rok Oh, M.D.*, Joon-Pio Hong, M.D.**

말기 압박궤양에 있어서 일측성 골반제거술의 임상례

이성수·홍종원·정윤규·오진록*·홍준표* *

Abstract

  One of the most common problems in cord injury is pressure sores. In the early stage of pressure sores, the wound can be covered by advancing or transpositioning a local myocutaneous flap. However, it can be a great challenge to treat end-stage paraplegic patient who underwent multiple prior flaps, where continuous treatment is needed to prevent recurrent pressure sore due to infection and metabolic drain. In these patients, a local myocutaneous flap may be very difficult for coverage of the wounds. Therefore, hemipelvectomy may be considered.
  The authors performed a hemipelvectomy on a 33 year-old male paraplegic patient who presented with multiple, large wounds seen in end-stage pressure sores. He had had a compression fracture of the lumber spine 9 years ago during a motor vehicle accident. After a wide exicision of the wound, the anterior flap was used as a fillet-flap for reconstruction. On the sixth day postoperatively, secondary repair was done due to wound dehiscence and the postoperative results have been satisfactory thus far.