臀大肌岛状肌皮瓣联合生肌拔毒散治疗复杂性骶尾部褥疮

Gluteus Maximus Myocutaneous Flap Combined with Shengji Badu Powder in the Treatment of Complex Sacrococcygeal Bedsore

目的:探讨应用臀大肌岛状肌皮瓣联合生肌拔毒散治疗复杂性骶尾部褥疮的治疗方法及临床效果。方法:将符合标准的30例复杂性骶尾部褥疮患者,按照时间顺序随机分为治疗组和对照组,每组各15例,治疗组采用臀大肌岛状肌皮瓣联合生肌拔毒散治疗,对照组采用臀大肌岛状肌皮瓣治疗,治疗组与对照组均采用相同的手术方式,围手术期均选择持续负压引流及自制生肌拔毒散促进组织修复。结果:治疗组15例肌皮瓣全部成活,给予自制中药-生肌拔毒散外敷后创面Ⅰ期愈合11例,Ⅱ期愈合4例;对照组15例肌皮瓣全部成活,创面Ⅰ期愈合7例,Ⅱ期愈合3例,III期愈合5例。经随访6个月~36个月,治疗组肌皮瓣及供区软组织弹性及伤口愈合较对照组更好,无复发。结论 :岛状臀大肌肌皮瓣修复骶尾部褥疮是一种较好的治疗方法,操作简单,血运丰富,抗感染能力强,在修复巨大褥疮时更为有利,不需要特殊器械,中药生肌拔毒散可有效促进组织修复及改善术后软组织弹性,可在基层医院推广开展。

Objective： To explore the treatment and clinical effects of gluteus maximus island musculocutaneous flap combined with Shengji Badu powder in the treatment of complex Sacrococcygeal bedsore. Methods： 30 patients with complex appendix acne who met the criteria were randomly divided into treatment group and control group according to chronological order, with 15 cases in each group. The treatment group was treated with gluteus maximus island musculocutaneous flap combined with Shengji Badu powde. The control group was treated with gluteus maximus island muscle flap. Both the treatment group and the control group used the same surgical procedure. During the perioperative period, continuous negative pressure drainage and self-made muscle extraction were used to promote tissue repair. RESULTS： All the 15 cases of musculocutaneous flaps in the treatment group survived, and 11 cases of wound healing were performed in the first stage, and 4 cases were healed in the second stage after external application of self-made traditional Chinese medicine Shengji Badu powder. In the control group, 15 cases of musculocutaneous flap survived, 7 cases of wound healing in stage I, 3 cases in stage II, and 5 cases in stage III. After 6 months to 36 months of follow-up, the soft tissue and wound healing of the musculocutaneous flap and donor site in the treatment group were better than the control group, and there was no recurrence. Conclusion： The island gluteus maximus myocutaneous flap is a good treatment for repairing hemorrhoids in the appendix. It is easy to operate, rich in blood supply and strong in anti-infective ability. It is more beneficial in repairing huge hemorrhoids. No special equipment is needed. Shengji Badu powder can effectively promote tissue repair and improve postoperative soft tissue elasticity, which can be promoted in primary hospitals.