[Reconstruction using the tensor fasciae latae muscle flap].

OBJECTIVE

The tensor fasciae latae (TFL) muscle flap can be used for reconstruction of decubital ulcers in the trochanteric or ischial region.

INDICATIONS

Deep decubital ulcers in the gluteal or ischial area after debridement and exhaustion of conservative measures.

CONTRAINDICATIONS

Moribund or palliative patients who do not benefit from defect coverage and are likely to suffer a life-threatening complication. Noncompliant patients who cannot follow the postoperative recommendations or protocols in regard to positioning or recurrence prevention. The presence of extensive scars after previous operations in the donor area or irradiation of the donor area can lead to flap necrosis.

SURGICAL TECHNIQUE

The TFL flap is commonly used as a regional transposition flap. Rare cases of a free TFL flap have been described.

POSTOPERATIVE MANAGEMENT

Following surgery the patient needs to be positioned on the side or prone to prevent recurrence. Drains should be left for 5-7 days. Antibiotics are only needed in the case of persistent florid infection.

RESULTS

The TFL muscle flap is known to be a reliable flap for the coverage of ulcers in the ischial and trochanteric region following radical debridement. This flap can also be transferred with its sensitive nerve supply resulting in a reduced chance of a recurring ulcer.