负压封闭引流下骨水泥联合股后带蒂肌皮瓣移植治疗坐骨结节Ⅳ期压疮的疗效分析  

Analysis of clinical efficacy of bone cement combined with vacuum sealing drainage and pedicled posterior thigh musculocutaneous flap transplantation in the treatment of stageⅣischial tubercle pressure ulcers

作　　者：陈华 高磊 程景波 罗晓彬 刘坤 陈绪广 万朝茹 胡昭华 CHEN Hua;GAO Lei;CHENG Jingbo;LUO Xiaobin;LIU Kun;CHEN Xuguang;WAN Chaoru;HU Zhaohua(Department of Orthopaedic Trauma Surgery,Hanzhong Railway Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市铁路中心医院创伤显微骨科,陕西汉中723000 [2]西安医学院,陕西西安710021

出　　处：《中国美容整形外科杂志》2022年第6期350-352,362,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的观察骨水泥负压封闭引流联合股后带蒂肌皮瓣移植治疗Ⅳ期坐骨结节压疮的临床疗效。方法自2016年2月至2020年5月,汉中市铁路中心医院创伤显微骨科对收治的8例坐骨结节Ⅳ期压疮患者,均采用骨水泥股后带蒂肌皮瓣移植联合负压封闭引流技术治疗,分析患者再次感染情况、手术情况及伤口愈合时间。结果创面经骨水泥负压封闭引流处理1~2次后行股后带蒂肌皮瓣修复,7例皮瓣成活,1例远端部分皮肤表皮坏死,面积为2.0 cm×2.5 cm,创面换药后愈合;伤口愈合时间37~79 d,1例因污染于术后79 d愈合。术后随访1年,8例患者均无再次感染及压疮发生。结论骨水泥负压封闭引流联合股后带蒂肌皮瓣移植临床疗效可靠,是处理坐骨结节Ⅳ期压疮的有效方法。Objective To observe the clinical efficacy of bone cement combined with vacuum sealing drainage(VSD)and pedicled posterior thigh musculocutaneous flap transplantation in the treatment of stageⅣischial tubercle pressure ulcers.Methods From February 2016 to May 2020,8 patients with stageⅣsacrococcygeal pressure ulcers in our department were selected as research subjects.All patients were treated with bone cement combined with VSD and pedicled posterior thigh musculocutaneous flap transplantation.The wound reinfection,reoperation and wound healing time of all patients were retrospectively analyzed.Results These wounds were repaired with pedicled posterior thigh musculocutaneous flap after 1 to 2 times of bone cement and VSD treatment.Seven cases of flaps survived,and one distal part of epidermis was necrotic with an area of 2.0 cm×2.5 cm.The wounds healed after dressing change.The healing time ranged from 37 to 79 days.One case healed at 79 days after operation due to fecal contamination.All patients were followed up for 1 year,no reinfection or pressure ulcers occurred in 8 patients.Conclusion The bone cement combined with VSD and pedicled posterior thigh musculocutaneous flap has reliable clinical efficacy.This is an effective method to treat stageⅣischial tubercle pressure ulcers of high paraplegia.

关 键 词：骨水泥 肌皮瓣移植 Ⅳ期压疮 坐骨结节压疮 负压封闭引流 

分 类 号：R632.1[医药卫生—外科学]