Application in a Stage IV Pressure Injury of the Ischium and Greater Trochanter
Abigail E. Chaffin MD, FACS, CWSP, MAPWCA
Professor & Chief, Division of Plastic and Reconstructive Surgery – Tulane University, School of Medicine
Initial Defect
Flap Advancement and Closure
Results
- Healed at week 6
- No infection or complications
- Index ulcers remained healed as of 14-months
Patient details
51-year-old male
Medical history
Paraplegic with history of prior stage IV sacral and ischial pressure injuries (PI)
Case details
- Presented with recurrence of left ischial and new trochanteric PI
- Previously had gluteal flap for sacral ulcer, V-Y hamstring flap for left ischial ulcer
- Condition worsened following electric offloading bed and wheelchair failures during loss of power from a hurricane
- Resulted in stage 4 ischial and trochanteric PI with underlying osteomyelitis
Application photos
Initial Defect
Myriad Matrix Applied
Flap Advancement and Closure
- Procedure: Excision of non-viable tissue, application of Myriad Matrix (3-Layer, 10 x 20 cm), gluteal myo-cutaneous rotation advancement flap
- Dressed with NPWT at 125 mmHg
- Goal of implanting Myriad was to eliminate dead space, minimize complications, and augment compromised
Week 6 - HEALED
- Healed
- No infection or complications
- Index ulcers remained healed as of 14-months
Results may vary. Dr. Chaffin has a consultancy agreement with Aroa Biosurgery Limited.
