Treatment of sacred scabs in cardiac patient

ABSTRACT

The sacral scab constitutesa very serious decubitus complication in the enduringly bedridden patients; It is much more serious when it occurs on a deleterious vascular land in which the cutaneous vascularisation is precarious and hostile to skinning. The musculo - cutaneous rotation flap of gluteus maximus muscle constitutes a very good flap in the treatment of the sacral scab constituted on these lands because of its vascular reliability, its well codified dissection and of the very good quality of cover that it procures. The musculo - cutaneous flap of big buttock brings by its good musculo-cutaneous vascularisation dependent on the two gluteal arteries of these patients, a filling and a cover of the scab consecrated of very good plastic quality. From October 95 to June 2002, we counted among the twenty cases of scabsmedicated sacral, 2 cases of sacral scabs occurring respectively in diabetic and arterial deleterious vascular land in 2 aged patients aged 65 and 67 years, valids and operated in cardiovascular surgery for coronary pathology. They underwent a quadriple and a triple coronary bypass, followed by a prolonged stay in resuscitation. These two patients benefited of a paring first of soft-tissue and the room of detachment and a resection of the bony prominence; The cover has been achieved by a musculo - cutaneous rotation flap of the superior half of the maximusgluteus muscle with preservation of its innervation. No complication is to deplore regarding the viability of the flap, neither recidivism of scab after 6 years of evolution. The two patients don't present any problem of marching or stability of their hip