Application in a Stage IV Pressure Injury of the Ischium and Greater Trochanter
Abigail E. Chaffin, MD, FACS, CWSP, MAPWCA
Professor of Surgery Chief, Division of Plastic and Reconstructive Surgery Program Director, Tulane University/Ochsner Clinic Plastic Surgery Residency Program Medical Director, MedCentris Wound Healing Institute Metairie Department of 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.