股二头肌长头肌瓣联合半V形股后筋膜皮瓣修复坐骨结节压疮  

Repair of pressure sores over ischial tuberosity with long head of biceps femoris muscle flap combined with semi-V posterior thigh fasciocutaneous flap

作　　者：海恒林[1] 申传安[1] 柴家科[1] 李华涛[2] 

机构地区：[1]解放军总医院第一附属医院全军烧伤研究所,北京100048 [2]解放军第九十八医院烧伤整形科

出　　处：《中华烧伤杂志》2012年第1期57-59,共3页Chinese Journal of Burns

基　　金：国家自然科学基金（30971128）

摘　　要：目的 观察应用股二头肌长头肌瓣联合半V形股后筋膜皮瓣修复坐骨结节压疮的临床疗效. 方法 选择2004年4月-2010年6月2家笔者单位收治的坐骨结节深度压疮患者8例共10处创面,压疮范围2cm×2 cm～6 cm ×4cm.设计股二头肌长头肌瓣和半V形股后筋膜皮瓣进行修复,其中股后筋膜皮瓣大小为10 cm ×6 cm ～13 cm×8 cm.统计术后皮瓣成活情况,并进行远期随访. 结果 术后皮瓣全部成活,其中9处压疮切口术后顺利愈合；1处因皮瓣下积液引流部位形成窦道,经换药治疗于术后25 d愈合.随访7～34个月,7例患者的皮瓣质地柔软,外形良好,无破溃；1例患者术后9个月压疮复发,再次利用该皮瓣修复得以愈合. 结论 该联合皮瓣手术操作简单、损伤小、抗压效果好、可重复利用,是修复坐骨结节压疮的一种新方法.Objective To explore the clinical effect of transplantation of the long head of biceps femoris muscle flap in combination with semi-V posterior thigh fasciocutaneous flap for repair of pressure sores over ischial tuberosity. Methods Eight patients with 10 deep pressure sores over ischial tuberosity were admitted to the First Affiliated Hospital to the PLA General Hospital and the 98th Hospital of PLA from April 2004 to June 2010.The wounds measured from 2 cm × 2 cm to 6 cm ×4 cm were covered with the long head of biceps femoris muscle flap and semi-V posterior thigh fasciocutaneous flap（ranged from 10 cm ×6 cm to 13 cm × 8 cm）.The condition of flaps was observed and followed up for a long time. Results All flaps survived.Nine wounds healed by first intention.Subcutaneous accumulation of fluids occurred in one wound with formation of a sinus at drainage site,and it healed after dressing change for 25 days.Patients were followed up for 7 to 34 months.Sore recurred in one patient 9 months after surgery,and it was successfully repaired with the same flap for the second time.Flaps in the other 7 patients appeared satisfactory with soft texture and without ulceration. Conclusions This combined flap is easy in formation and transfer,and it causes little side injury with good resistance against pressure.It is a new method for repair of pressure sore over sacral region.

关 键 词：修复外科手术 股二头肌长头肌瓣 股后筋膜皮瓣 坐骨结节 压疮 

分 类 号：R632.1[医药卫生—外科学]