应用股外侧肌肌瓣旋转填塞治疗大转子褥疮

Applying vastus lateralis muscle flap rotary stuffing in treatment of greater trochanter decubitus

目的探讨应用股外侧肌肌瓣旋转填塞治疗大转子部位深度褥疮的疗效。方法采用股外侧肌肌瓣旋转填塞治疗大转子部位深度褥疮12例15侧。切取肌瓣为20 cm×10 cm大小。肌瓣填塞后均取中厚皮片一期移植。结果肌瓣均成活。13处移植皮片完全成活,2处移植植皮片部分成活,边缘因感染坏死,经换药3~4周后愈合。10例患者获得随访,时间6~18（11±0.2）个月。植皮处颜色好,局部柔软,弹性佳,均未有褥疮复发。结论应用股外侧肌瓣旋转填塞治疗大转子部位深度褥疮,操作简单、转移方便、组织量大、手术风险小,临床效果较好。

Objective To investigate the curative effects of by application of vastus lateralis muscle flap rotary stuffing treatment to cure deep greater trochanter decubitus.Methods Vastus lateralis muscle flaps were used for rotating and packing the deep bedsore around greater trochanter in 12 cases（15 sites）.The muscle flap incision area was 20 cm×10 cm on average.After packing muscle flap,grafting of intermediate split thickness skin was done in one stage.Results All of the muscle flaps survived.Grafted skins in 13 sites completely survived,and 2 partly survived because of infection and necrosis in the rim.After dress changing for 3～4 weeks,the skins healed.10 cases patients were followed up for 6～18（11±0.2） months.The color of grafted skin was good and partially soft and elastic without relapse.Conclusions Good clinical effects can be provided by applying vastus lateralis muscle flap rotary stuffing in treatment of deep greater trochanter decubitus.Because it is simple to operate,easy to transfer,with larger tissues and low surgical risk.