股薄肌岛状复合组织瓣结合局部瘢痕筋膜瓣对修复窦腔型Ⅳ期坐骨结节压力性损伤的临床疗效  

Clinical effect of gracilis muscle island composite tissue flap combined with local scar fascia flap in repairing stage Ⅳ sinus cavity pressure injury in ischial tuberosity

作　　者：侯宏义 谢松涛 何香 张楠 官浩 Hou Hongyi;Xie Songtao;He Xiang;Zhang Nan;Guan Hao(Department of Burns and Cutaneous Surgery,Burn Center of PLA,the First Affiliated Hospital of Air Force Medical University,Xi′an 710032,China)

机构地区：[1]空军军医大学第一附属医院全军烧伤中心烧伤与皮肤外科,西安710032

出　　处：《中华损伤与修复杂志(电子版)》2025年第1期1-6,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：国家自然科学基金面上项目(82272268)。

摘　　要：目的探讨应用股薄肌岛状复合组织瓣结合局部瘢痕筋膜瓣修复窦腔型Ⅳ期坐骨结节压力性损伤的临床效果。方法回顾性分析2015年4月至2023年4月空军军医大学第一附属医院烧伤与皮肤外科收治的45例符合纳入与排除标准的窦腔型Ⅳ期坐骨结节压力性损伤患者临床资料。其中男38例,女7例;年龄23~64岁,平均41岁。在优化患者全身状况后,采用en bloc切除清创法完整切除压力性损伤病灶组织,经负压吸引结合封闭灌洗治疗后,行股薄肌岛状复合组织瓣结合局部瘢痕筋膜瓣填塞窦腔修复。结果术后所有复合组织瓣存活,外观良好、质地柔软。5例压力性损伤创面愈合不良,其中2例经床旁清创换药3周愈合,3例再次行手术清创缝合后愈合。3例供区愈合不良,经清创换药3周愈合。并发症总发生率为17.8%(8/45)。随访6~18个月,患者压力性损伤均未复发。结论股薄肌岛状复合组织瓣结合局部瘢痕筋膜瓣修复窦腔型Ⅳ期坐骨结节压力性损伤治疗效果可靠,并发症少,复发率低。Objective To explore the clinical effect of gracilis muscle island composite tissue flap combined with local scar fascia flap in repairing stageⅣsinus cavity pressure injury in ischial tuberosity.Methods A retrospective analysis was conducted on the clinical data of 45 patients with stageⅣsinus cavity pressure injury in ischial tuberosity who met the inclusion and exclusion criteria and were admitted to the Department of Burns and Cutaneous Surgery in the First Affiliated Hospital of Air Force Medical University from April 2015 to April 2023.There were 38 males and 7 females.The age ranged from 23 to 64 years,with an average of 41 years.After optimizing the overall condition of the patients,the pressure injury lesion tissues were completely removed through en bloc resection and debridement.After being treated with negative pressure suction combined with enclosed lavage,the gracilis muscle island composite tissue flap combined with local scar fascia flap was used to fill the sinus cavity for repair.Results All composite tissue flaps survived postoperatively,with a good appearance and soft texture.Five cases of pressure injury wounds had poor healing,of which two cases healed after three weeks of bedside debridement and dressing changes,and three cases healed after undergoing surgical debridement and suturing again.Three cases of poor healing in the donor area were healed after three weeks of debridement and dressing changes.The total incidence of complications was 17.8%(8/45).Follow-up for 6-18 months showed no recurrence of pressure injuries in the patients.Conclusion The combination of gracilis muscle island composite tissue flap and the local scar fascia flap for the repair of stageⅣsinus cavity pressure injury in ischial tuberosity is reliable,with few complications and a low recurrence rate.

关 键 词：压力性损伤 坐骨结节 股薄肌 复合组织瓣 瘢痕筋膜瓣 

分 类 号：R622[医药卫生—整形外科]