穿通支皮瓣修复臀骶部褥疮的临床疗效  

Clinical efficacy of artery pedorator-based flap in the repair of gluteal-sacral pressure sores

作　　者：李永林[1] 肖海涛[1] 祁强[1] 周兆平[1] 冈博昭 森口隆彦 

机构地区：[1]苏州大学附属第一医院烧伤整形科,215006 [2]日本川崎医科大学附属医院整形外科

出　　处：《中华烧伤杂志》2007年第1期32-35,共4页Chinese Journal of Burns

摘　　要：目的观察及评价采用穿通支皮瓣修复臀骶部褥疮的临床疗效。方法对26例臀骶部褥疮患者，按照缺损创面的位置和大小分类设计臀部、骶部穿通支岛状皮瓣或穿通支推进皮瓣进行修复。所切取皮瓣最大面积达20cm×15cm，穿通支外径在1．1mm以上，游离穿通支血管蒂长度为2．0～3．5cm。结果患者行皮瓣移植术后无皮瓣坏死、创面感染、瘘管形成等术后并发症，创面愈合较快。出院后随访患者6～24个月，皮瓣质地柔软，外形满意，局部褥疮未复发。结论穿通支皮瓣设计灵活、切取方便、血供可靠、不损伤臀部肌肉，供区大部分能直接缝合，是修复臀骶部褥疮的良好办法。Objective To investigate the clinical efficacy of artery perforator-based flap in the repair of gluteal-sacral pressure sores. Methods Gluteal artery perforator-based island flap and perforator-based flap were designed to repair the gluteal-sacral pressure sores of 26 patients according to the location and size of the wounds. The area of the biggest flap was 20 cm × 15 cm, the diameter of perforating vessel was above 1.1 mm, with the length of free pedicle ranging from 2.0 - 3.5 cm. Results All the flaps healed soon after operation, with no flap necrosis and postoperative complications, such as flap necrosis, wound infection and or formation, The color and texture of the flaps were good and the configuration was satisfactory, There was no recurrence of local bedsore in the follow-up period from 6 to 24 months. Conclusion The artery perforator-based flaps have the advantages of delicate texture, easy dissection, reliable blood flow, preservation of the gluteus maximus muscle and no need of skin grafting for the donor defects in most cases. It is an optimal method in surgical treatment of gluteal-sacral pressure sores.

关 键 词：褥疮 骶尾部 臀 外科皮瓣 穿通支 

分 类 号：R686[医药卫生—骨科学]