臀骶周围深度压疮的临床分型及手术治疗策略  

Clinical classification and surgical strategy for gluteal-sacral deep pressure ulcer

作　　者：汪赛 杨帆[2] 郑梁 徐风瑞[2] 李江华[2] 赵坤 甘泉 WANG Sai;YANG Fan;ZHENG Liang;XU Fengrui;LI Jianghua;ZHAO Kun;GAN Quan(Hubei University of Medicine,Shiyan 442000,China)

机构地区：[1]湖北医药学院,湖北十堰442000 [2]湖北医药学院附属太和医院整形美容烧伤科,湖北十堰442000

出　　处：《中国美容整形外科杂志》2023年第3期133-136,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨臀骶周围深度压疮的临床分型和手术治疗策略。方法回顾性分析自2019年10月至2021年12月,湖北医药学院附属太和医院整形美容烧伤科收治的45例(72处)骶尾部及其周围压疮患者的临床资料。根据创面特点分为窦道型28处、溃疡型20处和混合型24处。针对不同类型压疮,分别采用一期亚甲蓝标记、肿胀液创腔周围注射下彻底扩创、VSD覆盖,二期再次同样程序扩创、局部皮瓣转移或肌瓣填充腔隙,肌瓣和皮瓣分开设计,创腔基底闭式冲洗2周左右,供瓣区直接闭合或植皮。结果45例(72处)患者臀骶周围深度压疮经手术治疗后,64处愈合,4处三次手术后愈合不良,患者放弃治疗,4处周围愈合较差,经换药及局部清创后愈合。结论对深度压疮进行分型有利于合理选择不同的手术方式,遵循深度压疮的治疗原则及手术原则,能极大提高压疮的治愈率。Objective To explore the clinical classification and surgical strategy for gluteal-sacral deep pressure ulcer.Methods From October 2019 to December 2021,summary the clinical data of 45 patients(72 places)with gluteal-sacral deep pressure ulcer were chosen from Department of Burns and Plastic Surgery of Taihe Hospital Affiliated to Hubei University of Medicine.They were divided into 3 types according to the characteristics of the wound.There were 28 sinus sores,20 ulcer sores and 24 mixed sores.According to different types of pressure ulcer,the first stage include methylene blue marker,debride deep pressure under tumescent anasthesia,coverage cacuum sealing drainger(VSD),the second stage was used again with the same procedure,local skin metastasis and muscle flap filling the cavity,and muscle flap and flap were designed separately.The base of the cavity was ciosed for about 2 weeks,and the donor area was directly closed or skin graft.Results All the 72 deep pressure ulcers around the gluteal-sacral were healed by operation in 64 places,4 places had poor healing after three operations,the patients gave up treatment,4 places had poor healing around,healed afterdressing change.Conclusion The depth of pressure ulcer classification is advantageous to the reasonable choice of different surgical methods,principles and theoperation principle of deeptreatment of pressure ulcers can greatly enhance the cure rate of pressure ulcers.

关 键 词：臀骶周围 深度压疮 临床分型 手术策略 

分 类 号：R632.1[医药卫生—外科学]