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Management of these lesions should be comprehensive, including general measures and local care. Wound care occupies a large part of the treatment. For large skin loss, the treatment requires plastic surgery techniques for reconstruction. Myocutaneous advancement flaps are a good therapeutic option due to the provision of vascularized tissue within the skin defect. To ensure the success of the surgery, a good surgical technique preceeded by careful preparation of the patient in conjunction with the anesthesia team is imperative.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      We report the case of a 60-year-old bed ridden man for more than two months following an ischemic stroke with left spastic hemiplegia and loss of sensitivity. He was transferred to our surgical unit for the management of a chronic stage 4\n                      <jats:bold>PIs<\/jats:bold>\n                      in the sacral area complicated with cellulitis, subcutaneous abscess and severe sepsis. Initial management consisted of resuscitation measures combining fluid therapy, antibiotic therapy, analgesics, blood transfusion, nutritional support, physioteherapy, wound care as well as preventive measures and psychological support. Once the granulation tissues were fully developed, the patient underwent reconstruction surgery with a V\u2013Y myocutaneous advancement flap. The graft was successful with complete wound healing thereafter.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:bold>PIs<\/jats:bold>\n                      are a multifactorial, complex and disabling pathology that requires multidisciplinary care. Surgeons, anesthetists, nutritionists, physiotherapists, nurses must act in agreement in order to provide optimal treatment. Prevention is the rule.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.06.060","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T11:56:43Z","timestamp":1592395003000},"page":"15-21","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["The gluteus maximus V-Y advancement flap for reconstruction of extensive soft tissue loss following an advanced sacral pressure ulcer. A case report and mini review"],"prefix":"10.1097","volume":"73","author":[{"given":"Landry W.","family":"Tchuenkam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flobert","family":"Titcheu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aim\u00e9","family":"Mbonda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor","family":"Kamto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel M.","family":"Nwaha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor J.","family":"Kamla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel Noutakdie","family":"Tochie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-5-20260114","first-page":"30","article-title":"Pressure ulcers in the United States\u2019 inpatient population from 2008 to 2012: results of a retrospective nationwide study","volume":"62","author":"Bauer","year":"2016","journal-title":"Ostomy Wound Manage"},{"key":"R3-5-20260114","first-page":"201","article-title":"The burden of pressure ulcers in Spain","volume":"19","author":"Soldevilla Agreda","year":"2007","journal-title":"Wounds Compend. Clin. Res. Pract"},{"key":"R4-5-20260114","doi-asserted-by":"crossref","first-page":"e021769","DOI":"10.1136\/bmjopen-2018-021769","article-title":"Cohort study evaluating pressure ulcer management in clinical practice in the UK following initial presentation in the community: costs and outcomes","volume":"8","author":"Guest","year":"2018","journal-title":"BMJ Open"},{"key":"R5-5-20260114","first-page":"404","article-title":"Pressure ulcers and prevention among acute care hospitals in the United States","volume":"39","author":"Bergquist-Beringer","year":"2013","journal-title":"Jt. Comm. J. Qual. Patient Saf"},{"key":"R6-5-20260114","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/01.ASW.0000532475.11971.aa","article-title":"Prevalence and analysis of medical device-related pressure injuries: results from the international pressure ulcer prevalence survey","volume":"31","author":"Kayser","year":"2018","journal-title":"Adv. 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