应用臀大肌上部肌皮瓣联合腰骶筋膜皮瓣修复骶部巨大褥疮

Upper gluteal musculocutaneous flap with lumbo-sacral fasciocutaneous flap in repairing huge sacral bedsore

目的探究骶部巨大褥疮的修复方法。方法对10例骶部巨大褥疮的诊治资料进行回顾性分析。本组病例均采用臀大肌上部肌皮瓣联合腰骶筋膜皮瓣进行修复,并应用超常时间的持续负压引流技术预防死腔感染。结果10例(共20个)皮瓣全部存活,除1例于术后第3天发生切口裂开外,其余无并发症发生。皮瓣质地优良,外观及功能满意。结论采用臀大肌上部肌皮瓣联合腰骶筋膜皮瓣能修复较大面积的骶部褥疮,且不需要过多分离臀大肌及避免皮瓣供区植皮等烦琐操作,简便易行,尤其适用于大、中面积Ⅳ度骶部褥疮的非瘫痪患者,具有一定临床实用价值。

Objective To explore the method of repairing huge sacral bedsore. Methods A retro- spective analysis was made on 10 cases with huge sacral bedsores,which were repaired by transferring upper gluteal musculocutaneous flap together with lumbo-sacral fasciocutaneous flap, and by vacuum sealing technique to prevent dead cavity infection. Results After a follow-up of 3 to 24 months, all the flaps survived except 1 case with incision split open,whth out other complications. The texture, appearance and function of the flaps were satisfactory. Conclusions This method can be used to repair a huge sacral bedsore,without separating excessive gluteal muscle, and does not need skin grafting to repair the donor area of flap. The operation is easy. It has a certain clinical practical value, particularly suitable for those who were not paralysed, though suffering from middle or large area Ⅳ degree sacral bedsore.