应用腰臀部多种类型穿支皮瓣修复骶尾部巨大压疮的效果

Repairing sacroiliac refractoriness decubital necrosis wound with many types perforator flaps from waist and rump

目的探讨应用腰臀部3种类型穿支皮瓣修复骶尾部巨大压疮的手术方法和疗效。方法 19例骶尾部压疮,创面范围为11 cm×10 cm～17 cm×14 cm,依其大小、形态、位置,分别采用双侧臀上动脉、第4腰动脉及单侧腰臀部巨型角形瓣等3种类型穿支皮瓣移位修复。结果所有穿支皮瓣全部成活,伤口均一期愈合。随访10个月～7年,皮瓣无臃肿,色泽与周围皮肤相似,无压疮复发。结论根据穿支动脉分布状况、压疮大小及位置分别设计以上3种类型穿支皮瓣,血供丰富可靠,操作简便,手术创伤小,供区可直接缝合,是修复骶尾部巨大压疮的可靠、有效的方法。

Objective To investigate the operating approaches and therapeutic effect by shifting with three types perforator flaps from waist and rump in repairing sacroiliac decubital necrosis. Methods According to the wound size,appearance and location,19 patients,whose wound size ranged from 11cm* 10cm to17cm* 14cm,were reconstructed with three perforator flaps,including double side superior gluteal and the forth waist atery,a side huge horn shaped flaps. Results All the flaps survived completely with primary healing and had a similar color as the surrounding skin without fat. Nineteen cases were followed up for 10 months- 7years without recurrence. Conclusion According to the distribution of the perforators and the location and the size of the wound,the three types flaps with plentiful blood supply were designed to repair sacroiliac decubital necrosis easily. This surgical method can close the defect directly with less injury and provesto be reliable and efficient.