Pressure Sores

Question 1

Stages in pressure sore development

Answer 1

stage 1 - 30 minutes, reversible hyperemia
stage 2 - ischemia that can occur 2-6 hours, requires at least 36hrs to resolve
stage 3 - necrosis that doesn’t resolve
stage 4 - ulceration after necrosis

Question 2

sitting protocol

Answer 2

15 min q2
30min q2
1hr q2
goes up by an hr each week

Question 3

ischial pressure sore

Answer 3

V to Y posterior thigh flap off the descending inferior gluteal artery branch smh the profound artery perforator branches
Can move the hamstrings into place
can do adipofascial and turn in the skin or mobilize the biceps femoris/semitendinosis
whichever way you rotate remember that the profunda femurs perfrotaing vessels are 10cm inferior to ischium

Question 4

sacral pressure sore

Answer 4

Gluteal flap
PSIS to greater trochanter 1/3rd the distance is the SGA
PSIS to trochanter approx 1/2 way under piriformis is the IGA
don’t forget to mark the boarders of the gluteus muscle
PSIS, grater trochanter, ischium sacrum mark where IGA and SGA are located

you can do a back cut toward greater trochanter to take out a burrow triangle, you can not close and back graft