The modified bilobed flap for reconstructing sacral decubitus ulcers  

作　　者：Xiangong Jiao Chunxiao Cui Sally Kiu-Huen Ng Zhangjia Jiang Chihui Tu Jiemin Zhou Xiandong Lu Xianwen Ouyang Tong Luo Ke Li Yixin Zhang 

机构地区：[1]Plastic,Reconstructive and Burn Centre,Liuyang People’s Hospital,49 Renmin Middle Road,Liuyang 410300,Hunan,China [2]ENT Institute,Eye&ENT Hospital,Fudan University,83 Fenyang Road,Shanghai 200011,China [3]Department of Facial Plastic and Reconstructive Surgery,Eye&ENT Hospital,Fudan University,83 Fenyang Road,Shanghai 200011,China [4]NHC Key Laboratory of Hearing Medicine,Fudan University,83 Fenyang Road,Shanghai 200011,China [5]Department of Plastic Surgery,Austin Hospital,145 Studley Road,Melbourne 3084,Australia [6]Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine,639 Zhi Zao Ju Road,Shanghai 200011,China

出　　处：《Burns & Trauma》2020年第1期24-29,共6页烧伤与创伤（英文）

基　　金：supported by funding from the following programs:The National Natural Science Foundation of China(Grant Number:81772098);the Clinical Multi-Disciplinary Team Research Program of the Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine;the Clinical Research Program of the Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine;and the Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support.

摘　　要：Background:Sacral pressure ulcers are associated with high morbidity and,in some cases,result in mortality from severe sepsis.Local flaps are frequently used for reconstruction of stage III and IV pressure ulcers.An ideal flap should be simple to design,have a reliable vascular supply and minimal donor site morbidity.Our study evaluates the use of a bilobed flap based on the superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery to reconstruct the sacral pressure ulcer.Case presentation:We performed a retrospective analysis of paraplegic patients with sacral pressure ulcers treated with our bilobed flaps from January 2015 to December 2019.A description of our management,operative protocol,outcome and complications is outlined.Seven paraplegic patients(6 male,1 female;average age 53.1 years)with sacral pressure ulcers were treated with our bilobed flap based on the superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery.The average size of the pressure ulcers was 7×5 cm(range 6.2×4.5 cm to 11×10 cm).All 7 flaps survived.The patients were followed up for 12 months without significant complications,such as flap necrosis or recurrence.Conclusions:The superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery reliably supplies the bilobed flap.The superior cluneal nerve can be included in the design.The technique is simple and reliable.It should be included in the reconstructive algorithm for the management of sacral pressure ulcers.

关 键 词：SACROCOCCYGEAL Pressure sore Superior cluneal nerve Bilobed flap Superior gluteal artery Fourth lumbar artery 

分 类 号：R68[医药卫生—骨科学]