Redesigning to V-Y Fasciocutaneous Flaps: Optimizing Outcomes in Patients With Pressure Injuries and Spinal Cord Injuries

Surgical treatment for patients with stage 4 pressure injury and spinal cord injury can be difficult because the complication rates are high. Several flaps have been described, but there is no consensus in favor of any flap. The V-Y fasciocutaneous flap, although commonly used, lacks a simple, standardized, step-by-step description. This study introduces a novel, simplified approach to the design and execution of the V-Y flap to improve the outcomes for these patients. This study aimed to evaluate the efficacy of 57 newly planned V-Y fasciocutaneous flaps for achieving predictable and improved outcomes in 40 patients with stage 4 pressure injury and spinal cord injury. Our technique demonstrated notable efficacy in terms of defect coverage (maximum of 196.35 cm²) and linear advancement (maximum of 12 cm). Interestingly, our approach records complication and recurrence rates equal to those of other flap types reported in the literature, with the advantage of not having full or partial necrosis. We describe an easy, highly reproducible, new technique of marking, tracing, dissecting, and advancing the V-Y fasciocutaneous flap so that its simplicity makes it the preferred choice of local flaps for this type of lesion; additionally, this technique is applicable to defects of varying sizes in any anatomical region.