Arch Plast Surg.  2016 Nov;43(6):586-589. 10.5999/aps.2016.43.6.586.

Multidisciplinary Approach to an Extended Pressure Sore at the Lumbosacral Area

• Yoon S
• Jeong E
• Lázaro HA

• KMID: 2358310
• DOI: http://doi.org/10.5999/aps.2016.43.6.586

Abstract

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.

Keyword

Pressure ulcer; Osteomyelitis; Epidural abcess; Psoas abscess

MeSH Terms

Abscess
Adult
Debridement
Epidural Abscess
Female
Hip
Humans
Myocutaneous Flap
Osteomyelitis
Pressure Ulcer*
Psoas Abscess
Skin
Spine
Superficial Back Muscles
Tissue Donors
Walking
Wheelchairs
Wounds and Injuries