臀上动脉穿支肌皮瓣修复腰骶部深度缺损难愈合创面  

Repairing lumbosacral chronic deep defect wounds with superior gluteal artery perforator myocutaneous flap

作　　者：沈佳祚 官世水 郑毅全 张力 SHEN Jia-zuo;GUAN Shi-shui;ZHENG Yi-quan;ZHANG Li(Dept of Orthopaedics,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou,Fujian 363000,China)

机构地区：[1]福建医科大学附属漳州市医院骨科,福建漳州363000

出　　处：《临床骨科杂志》2023年第6期809-812,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨臀上动脉穿支肌皮瓣修复腰骶部深度缺损难愈合创面的临床疗效。方法采用臀上动脉穿支肌皮瓣修复15例腰骶部深度缺损难愈合创面患者。记录受区肌皮瓣成活情况,并观察肌皮瓣颜色、温度、肿胀程度。采用视觉模拟量表(VAS)评分评估受区外观满意度。结果患者均获得随访,时间6~18个月。术后1周肌皮瓣温度为35.0~36.2(35.9±0.1)℃。术后15例臀上动脉穿支肌皮瓣全部成活;术后1例肌皮瓣最远端部分坏死,经扩创、拉拢缝合后愈合良好,其余14例创面均一期愈合。术后均未发生感染、脂肪液化、血肿等并发症。术后3周,VAS评分评估受区外观满意度:1~6(2.3±0.1)分,其中满意11例,基本满意4例;肌皮瓣色泽良好、质地柔软、弹性良好。结论臀上动脉穿支肌皮瓣修复腰骶部深度缺损难愈合创面手术操作简单,术后肌皮瓣血供好、成活率高,效果显著。Objective To investigate the clinical effect of superior gluteal artery perforator myocutaneous flap in repairing deep lumbosacral chronic deep defect wounds.Methods The 15 cases of lumbosacral chronic deep defect wounds were repaired with superior gluteal artery perforator myocutaneous flap.The survival situation of the recipient myocutaneous flap was recorded,and the color,temperature and swelling degree of the myocutaneous flap were observed.Visual analogue scale(VAS)was used to evaluate the appearance satisfaction of the recipient area.Results All patients were followed up for 6~18 months.The musculocutaneous flap temperature was 35.0~36.2(35.9±0.1)℃ at 1 week after operation.All 15 cases of superior gluteal artery perforator myocutaneous flaps survived after surgery.The farthest part of the musculocutaneous flap was necrotic in 1 case after operation,and the wound healed well after expansion and suture,and the other 14 cases of wounds healed in one-stage.There were no complications such as infection,fat liquefaction and hematoma.Three weeks after surgery,the appearance satisfaction of the recipient area assessed with VAS:1~6(2.3±0.1)points,of which 11 cases were satisfied,and 4 cases were basically satisfied.Musculocutaneous flaps had good color,soft texture and good elasticity.Conclusions The superior gluteal artery perforator musculocutaneous flap has the advantages of simple operation,good blood supply,high survival rate and remarkable effect in repairing deep lumbosacral chronic deep defect wounds.

关 键 词：臀上动脉 穿支肌皮瓣 腰骶部深部缺损 创面修复 

分 类 号：R622.1[医药卫生—整形外科] R659[医药卫生—外科学]