The rehabilitation of pressure sores after myocutaneous flap surgery
Bih, L.I.; Lu, S.Y.
Journal of the Formosan Medical Association 88(4): 387-393
1989
ISSN/ISBN: 0371-7682 PMID: 2794940 Document Number: 333829
Fourteen myocutaneous flap operations for the treatment of pressure sores were performed from June 1984 to May 1986. After surgery, the patient was immobilized in a prone position in order to avoid direct pressure on the flap and to minimize motion of the hips. When the daily drainage from the wound was less than 10ml, the drain was removed. Hip flexion and body turning every 2 hours (except direct pressure on the flap) were started the day after the removal of the drain. In the meanwhile, a 2-5kg sandbag was placed on the flap until the flap showed mild redness which disappeared within 10 minutes. Under close observation, the duration increased step by step till the flap could tolerate compression for 2 hours continuously. Then the patient was allowed to assume a position with the body weight directly on the flap. Each session of pressure training lasted only until the flap showed mild redness and faded away quickly. The pressure training was finished when the flap was able to tolerate the patient's body weight for approximately 2 hours. The results showed that the myocutaneous flap could bear weight as normal skin 18.5 +/- 5.3 days after the operation; the average duration of hospitalization for treating one sore with a myocutaneous flap was 28.2 +/- 8.7 days. The time involved in pressure training after a myocutaneous flap operation may progress more quickly than that after a conventional skin flap operation.