臀部穿支皮瓣治疗骶尾部褥疮100例临床分析

The clinical analysis of sacral pressure ulcers utilizing perforator flaps

目的探讨应用各种类型臀部穿支动脉皮瓣修复骶尾部褥疮的手术方法及临床效果。方法对应用穿支皮瓣修复治疗骶尾部褥疮的100例病例按皮瓣类别分组进行分析。根据缺损部位及大小分为两组,分别设计单纯带蒂穿支皮瓣(旋转或移位皮瓣)、岛状穿支皮瓣(推进或移位)修复骶尾部褥疮,并对其治愈率、并发症发生率和复发率等进行分析。结果 100例病例中84例皮瓣全部成活,伤口均一期愈合。随访1～7年,皮瓣质地优良,外形满意,溃疡无复发。结论穿支蒂皮瓣设计灵活,切取方便,血供可靠,不损伤臀部肌肉,供区无需植皮,是修复臀骶部褥疮的理想方法;旋转或移位皮瓣手术操作较简单,成功率高,但移动性差,仅适用于皮肤缺损小的褥疮;岛状皮瓣移动性高,操作相对复杂,手术风险大,适用于皮肤缺损较大或周围瘢痕较多的褥疮。

Objective To explore the clinical effects of various types Perforator Flap in the Reconstruction of Sacral Pressure Ulcers.Complications were analyzed.Methods A retrospective study from 100 operated cases using the superior gluteal artery perforator（SGAP） for sacral pressure ulcer is reported.According to defect parts and size,the patients are divided into two groups,which were designed with pure pedicle or island flaps respectively.Results The defect areas ranged from 4cm×5cm^10cm×12cm and 84 cases of 100 were healed primarily.We analyze two group＇s Complications and assess their risk factors.There is a statistical difference between the two groups.Conclusion The perforator flaps is an ideal method for the treatment of Ischia-sacral pressure ulcer.The pure pedicle flap operation is simple with low risk,but has low mobility,which is applicable to smaller defects.The island flap is a relatively complicated operation and has high mobility;the operation is applicable to ulcer bigger defect.