Primary closure of trochanteric decubitus ulcers: the bipedicle tensor fascia lata musculocutaneous flap.

A surgical procedure is described for the definitive treatment of trochanteric decubitus ulcers. It combines the advantages of the bipedicle skin flap and the musculocutaneous flap; that is, a large area of skin is provided with a thick protective padding consisting of fat, fascia, and muscle richly vascularized by the musculocutaneous perforating circulation. The disadvantages of either flap alone (i.e., dependence on dermal blood supply and skin grafting of the donor bed) are avoided. In patients who are traditionally the most difficult nursing problems, this one-stage reconstructive procedure results in shorter operating room time, easier postoperative care, shorter hospital convalescence, and an enduring protection against recurrent trochanteric pressure problems.