Flap surgery to cover olecranon pressure ulcers in spinal cord injury patients

Plastic and Reconstructive Surgery
S Rubayi, Y Kiyono

Abstract

In the quadriplegic patient, the periolecranon region is subjected to continuous and permanent mechanical shearing and pressure forces. As the sensation of this region is partially impaired secondary to the level of the spinal cord injury, this anatomical area is prone to develop bursitis and then a chronic open draining wound. This type of wound is refractory to conservative measures. Surgical closure of this functional area can represent a challenge to the plastic and reconstructive surgeon because not all of the surgical options available are suitable for spinal cord injury patients. Therefore, we describe our clinical experience, which consists of seven patients with traumatic complete quadriplegia treated between 1989 and 1998 (all patients were male) who presented with an open olecranon ulcer, septic bursitis, or aseptic bursitis, and who underwent surgical closure by direct closure, local arm fasciocutaneous flap, or cross-chest flap to cover the periolecranon soft-tissue defects. The follow-up period ranged from 3 months to 8 years (mean, 44 months). All types of flaps achieved wound closure without losing range of motion at the elbow; however, at 10 to 12 months after surgery, an olecranon pressure ulcer or septic burs...Continue Reading

References

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Citations

Jun 7, 2003·Annals of Plastic Surgery·Lieselotte Frost-Arner, Ola Björgell
Aug 7, 2008·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·H-G DamertW Schneider
Sep 11, 2012·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Sinan OksüzHüseyin Karagöz
Dec 17, 2008·The Journal of Hand Surgery·Robert W WysockiMark S Cohen
Jul 10, 2007·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·L PrantlB Füchtmeier
Nov 28, 2015·The Journal of Hand Surgery·Christopher O BayneRobert W Wysocki
May 26, 2006·International Wound Journal·Bishara S Atiyeh, Shady N Hayek

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