[Treatment of chronic decubitus ulcers by fascio-cutaneous and cutaneous flaps in paraplegic patients].

Together with musculocutaneous flaps, cutaneous and fascio-cutaneous flaps have proved to be the most successful for the closure of decubital ulcers in paraplegic patients. These complicated and infected skin/soft tissue defects must not be closed until the ulcers have been cleaned locally as far as possible of necrotic and suppurating secretions and coverings and a specific antibiotic treatment administered. From October 1986 to May 1988, a total of 67 decubital ulcers in 53 patients were covered with fascio-cutaneous or cutaneous flaps after a preparatory local treatment. Except in 6 patients who had preoperative sepsis with temperatures ranging from 38 degrees C to 39 degrees C (infection of the urinary tract) no antibiotic treatment was used perioperatively. As a result, we observed a reduced rate of local complications (11%) and a shorter duration of treatment and hospitalization (about 6 weeks less) even though these patients were at risk of complications in view of the average ulcer size, frequency of bone involvement and the frequent presence of multiple ulcers.