Perineal reconstruction following tumor resection is often complicated by irradiated tissue and multiple comorbidities, making reconstruction challenging. Management of these conditions can have complication rates as high as 66 percent, which further compounds the costs and implications of managing these wounds. These complication rates can be significantly decreased using flap closure rather than primary closure. Pressure ulcers also occur in patients with poor overall health, multiple comorbidities, and often numerous prior failed reconstruction attempts. Comprehensive management of pressure sores is a significant burden to the health care system, at a cost of $9.1 to $11.6 billion per year. There exists an extensive body of literature describing the pathophysiology and management strategies for these problems. The focus of this article is to discuss best solutions for perineal and pressure ulcer reconstruction, and to explore alternative options for reconstruction.
After viewing this course, the participant should be able to:
- Understand variations of the myocutaneous rectus abdominis muscle flap as it is used for perineal reconstruction and discuss common and alternative options for perineal defect reconstruction.
- Review primary options and alter-natives to pressure sore reconstruction if the primary option is not available and recognize when pressure sore reconstruction is not feasible.
- Highlight pertinent anatomy and techniques for the flaps described.
Jeffrey G. Trost, M.D.; Alejandro Gimenez, M.D.; Kimberly Goldie Staines,
M.S.(O.T.); David T. Netscher, M.D.
Plastic and Reconstruction Surgery®Editors: Editor-in-Chief: Rod J. Rohrich, MD
Co-Editor: James M. Stuzin, MD
Section Editors: Donald H. Lalonde, MD; John YS Kim, MD
AMA PRA Category 1 CreditTM: 1.0
Patient Safety Credit: 0.5
Media:Journal Article, video
Release Date: 12/01/2021
Expiration Date: 12/01/2024
Estimated time to complete this course: 1 hour
*Course access ends on course expiration date
Directly provided by the American Society of Plastic Surgeons® (ASPS®)
The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The ASPS designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.Disclosures
Link to Current Disclosures
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