双侧臀上动脉穿支蒂四叶皮瓣修复骶尾部巨大压疮  

PEDICLED SUPERIOR GLUTEAL ARTERY PERFORATOR BILATERAL QUADRILOBED FLAPS FOR REPAIR OF LARGE SACROCOCCYGEAL PRESSURE SORES

作　　者：海恒林[1] 李华涛[1] 陈杨[2] 李强[1] 吴胜刚[1] 王黎丽[1] 严雷[1] 周晓英[1] 

机构地区：[1]解放军第98医院浙江湖州烧伤整形科,313000 [2]解放军第98医院浙江湖州 皮肤科

出　　处：《中国修复重建外科杂志》2013年第3期308-311,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：南京军区医学科技创新课题资助项目(11MA006)~~

摘　　要：目的探讨双侧臀上动脉穿支蒂四叶皮瓣修复骶尾部巨大压疮的疗效。方法 2003年6月-2011年8月,采用双侧臀上动脉穿支蒂四叶皮瓣修复6例截瘫患者骶尾部巨大压疮。男2例,女4例;年龄37～62岁,平均45.6岁。压疮形成时间3～26个月,平均8.4个月。根据美国国家压疮顾问小组(NPUAP)分度标准均为Ⅳ度。压疮范围为15 cm×13 cm～18 cm×16 cm。皮瓣切取范围18 cm×14 cm～21 cm×15 cm。结果术后皮瓣均成活;5例切口Ⅰ期愈合,1例术后6 d切口部分裂开,经换药治疗26 d后愈合。6例均获随访,随访时间6～24个月,平均12.5个月。皮瓣质地及弹性好,无破溃,外形满意。结论双侧臀上动脉穿支蒂四叶皮瓣可修复骶尾部巨大压疮,修复后骶臀部外形平整,抗压效果好。Objective To investigate the effectiveness of pedicled superior gluteal artery perforator bilateral quadrilobed flaps for repairing large sacrococcygeal pressure sores. Methods Between ]une 2003 and August 2011, 6 paraplegia patients with large sacrococcygeal pressure sores were repaired with the pedicled superior gluteal artery perforator bilateral quadrilobed flaps. There were 2 males and 4 females with an average age of 45.6 years （range, 37-62 years）. The mean disease duration was 8.4 months （range, 3-26 months）. According to National Pressure Ulcer Advisory Panel （NPUAP） standard, 6 cases rated as degree IV. The size of pressure sores ranged from 15 cmx 13 cm to 18 cm x 16 cm. The size of flaps ranged from 18 cm ~ 14 cm to 21 cm ~ 15 cm. Results After operation, all flaps survived successfully. The wounds healed by first intention in 5 cases; partial dehiscence of incision occurred in 1 case, which was cured after dressing change for 26 days. Six patients were followed up 6-24 months （mean, 12.5 months）. The appearance and texture of the flaps were smooth and soft with good elasticity and no ulceration. Conclusion Pedided superior gluteal artery perforator bilateral quadrilobed flaps can repair large sacrococcygeal pressure sores. The appearance of flaps is smooth and has good compression-resistance effect.

关 键 词：骶尾部压疮 臀上动脉穿支 四叶皮瓣 创面修复 

分 类 号：R622[医药卫生—整形外科]