多种皮瓣的灵活应用修复深度压疮创面  

Flexible application of multiple flaps in the repair of deep pressure sores

作　　者：孟宪熙 王先成[1] 李晓芳[1] 杨远明 熊祥[1] 孙杨[1] 李文波 MENG Xian-xi;WANG Xian-cheng;LI Xiao-fang;YANG Yuan-ming;XIONG Xiang;SUN Yang;LI Wen-bo(Department of Bum and Plastic Surgery,The Second Xiang Ya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院烧伤整形科,湖南长沙410011

出　　处：《中国美容整形外科杂志》2021年第11期686-688,700,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨局部皮瓣、自由式穿支皮瓣、臀上下动脉穿支皮瓣、股前外侧穿支皮瓣在深度压疮创面修复中的应用及选择。方法自2015年8月至2019年1月,中南大学湘雅二医院烧伤整形科收治108例深度压疮患者,共120处创面,根据创面的位置、深度、大小等选择不同方法进行修复,其中局部皮瓣46处,自由式穿支皮瓣40处,臀上动脉穿支皮瓣12处,臀下动脉穿支皮瓣5处,股前外侧带蒂穿支皮瓣17处。结果皮瓣均全部成活,其中6处发生并发症,经对症治疗后痊愈。术后所有患者随访6~12个月,压疮皮瓣恢复良好,患者无复发。结论根据深度压疮的创面大小、位置、深度等因素合理的选用局部皮瓣,自由式穿支皮瓣,臀上、下动脉穿支皮瓣,股前外侧穿支皮瓣进行修复均可获得良好的治疗效果。Objective To explore the application and selection of local flap, freestyle perforator flap, superior and inferior gluteal artery perforator flaps and anterolateral thigh perforator flap in the repair of deep pressure sores. Methods From August 2015 to January2019, 108 patients with deep pressure sores(120 wounds) were hospitalized. Type of flaps was chosen according to the position, depth and size of pressure sores. There were 46 local flaps, 40 freestyle perforator flaps, 12 superior and inferior gluteal artery perforator flaps and17 anterolateral thigh perforator flaps. Results All flaps survived. Complications were observed in 6 flaps and cured after symptomatic treatment. After follow up of 6 to 12 months, the flaps recovered well and no recurrence was found. Conclusion According to the position,depth and size of pressure sores, reasonable selection of local flap, freestyle perforator flap, superior and inferior gluteal artery perforator flap and anterolateral thigh perforator flap can lead to a satisfactory outcome.

关 键 词：褥疮 压疮 皮瓣修复 穿支皮瓣 负压吸引 

分 类 号：R632.1[医药卫生—外科学]