旋转肌皮瓣覆盖创面治疗骶臀部难治性压疮

Rotating muscle flap in the treatment of refractory bedsore at sacrococcygeal region

选择2002-06/2007-06四川大学华西医院整形烧伤科收治的骶臀部压疮患者16例,骶尾部压疮11例,坐骨结节周围压疮5例。患者对治疗方案及实验均知情同意,且得到医院伦理道德委员会批准。将患者置于翻身床加强翻身,避免创面局部受压,并行压疮彻底清创,湿敷换药加强引流,待创面新鲜后旋转邻近合适的肌皮瓣修复创面,供皮区错位缝合。术后16例患者中有1例皮瓣贴附欠佳,加压包扎后愈合;其余15例均获得Ⅰ期愈合。随访3个月￣5年未见压疮复发。旋转肌皮瓣覆盖创面被证实为治疗骶尾部难治性压疮较为有效的方法之一。

Sixteen patients with bedsore at sacrococcygeal region were selected from Department of Burns and Plastic Surgery, West China Hospital of Sichuan University between June 2002 and June 2007 including 11 cases of bedsore at sacrococcygeal region and 5 cases of bedsore surrounding ischial tuberosity. The informed consent was obtained from the patients, and the experiment was permitted by the Hospital Ethics Committee. The patients were set on the rotating beds to avoid pressing the wound surfaces, debrided and wet dressed until no necrotic tissues left. Then nearby skin flaps or myocutaneous flaps were rotated to restore wound surfaces, and the donor sites were sutured in malposition. After operation, the skin flap did not attach well in one case, but healed by dressing with pressure at last; the rest 15 cases healed in the first period. No relapse of bedsores was found in any case during the follow-up ranged from 3 months to 5 years. Rotating muscle flap is proved to be one of the effective therapies for refractory bedsore at sacrococcygeal region.