改良技术在下部臀大肌菱形肌皮瓣修复坐骨结节压疮的临床应用  

Clinical application of improved technique in repairing ischial tuberosity pressure ulcer with lower gluteus maximus rhomboid myocutaneous flap

作　　者：王鑫[1] 岳立明 马志国 赵风林[1] 吴鹏 WANG Xin;YUE Liming;MA Zhiguo;ZHAO Fenglin;WU Peng(Department of Burns and Plastic Surgery,Jinan Third People's Hospital,Jinan 250132,China)

机构地区：[1]济南市第三人民医院烧伤整形科,山东济南250132 [2]山东第一医科大学第一附属医院整形美容与创面修复外科,山东济南250014

出　　处：《中国美容整形外科杂志》2025年第3期158-159,166,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨改良技术在下部臀大肌菱形肌皮瓣修复坐骨结节压疮的安全性和临床应用效果。方法 回顾性分析自2019年6月至2022年7月,济南市第三人民医院烧伤整形科收治的5例截瘫合并坐骨结节Ⅳ期压疮患者的临床资料,采用改良下部臀大肌菱形肌皮瓣结合逐层递进式减张缝合技术修复创面。结果 5例患者术后随访3个月至3年。所有皮瓣均成活,外形饱满、质地柔软、耐磨。未出现血肿、皮瓣坏死等并发症,未再发生压疮复发。结论 经改良的下部臀大肌菱形肌皮瓣结合逐层递进式减张缝合技术修坐骨结节压疮,具有操作方便、并发症较少、皮瓣耐磨等优点。Objective To report a surgical approach for the repairing pressure ulcers on the ischial tuberosity using an improved lower gluteus maximus rhomboid muscle flap, and to evaluate its safety and clinical outcomes. Methods From June 2019 to July 2022, a retrospective analysis was conducted on five patients with paraplegia and stage Ⅳsciatic tuberosity pressure ulcers, treated from Department of Burns and Plastic Surgery, Jinan Third People's Hospital. The ulcers were repaired using a modified rhomboid flap of the lower gluteus maximus muscle combined with a layer-by-layer progressive tension-reducing suture technique. Results Postoperative follow-up ranged from 3 months to 3 years, with an average duration of 1 year. All flaps survived successfully, exhibiting a full shape, soft texture, and wear resistance. No complications such as hematomas or flap necrosis occurred, and no recurrence of pressure ulcers was observed following. Conclusion The modified rhomboid flap of the lower gluteus maximus muscle, combined with a layer-by-layer progressive tension-reducing suture technique, is an effective approach for repairing sciatic tuberosity pressure ulcers. This method offers advantages such as ease of operation, minimal complications, and durable flaps.

关 键 词：肌皮瓣 压疮 坐骨结节 并发症 

分 类 号：R658.3[医药卫生—外科学]