应用双侧臀上动脉穿支岛状皮瓣修复骶尾部巨大压疮

Repairing sacroiliac refractoriness decubital necrosis wound with double superior gluteal perforator island skin flaps

目的:探讨应用双侧臀上动脉穿支岛状皮瓣修复骶尾部巨大压疮的手术方法和疗效。方法:11例骶尾部巨大压疮,均采用双侧臀上动脉穿支岛状皮瓣移位修复;创面范围11cm×10cm～17cm×14cm,皮瓣大小20cm×11cm～22cm×14cm。结果:11例双侧臀上动脉穿支皮瓣全部成活,压疮创面一期愈合;随访1～3年,皮瓣不显臃肿,无凹陷、感染、坏死,臀部外观均良好。结论:臀上动脉穿支密集,血供丰富,营养皮肤及皮下组织范围大,故臀上动脉穿支岛状皮瓣治疗骶尾部压疮疗效满意,而使用双侧该皮瓣则是修复骶尾部巨大压疮的最佳选择。

Objective To investigate the operating approaches and therapeutic effect by shifting with double superior gluteal perforator island skin flaps （DSGPISF） in repairing sacroiliac decubital necrosis. Methods 11 patients, the wound＇s surface 11cm ×lOcm ×17cm ×14cm,the flap＇s size 20cm ×11cm 1122cm ×14cm,were received with sacroiliacdecubital necrosis underwent reconstructive,operations by shifting with the DSGPISF. Results All the flaps survived completely with primary healing. 11cases were followed up for 1-3years, without fat and clumsy tissues, free from infection and clumsy tissues, free from infection and introcession, with no necrosis, and all the fundamentic appearances presented satisfactory. Conclusions Blood supply of superior gluteal perforator arteries that are plentiful, nutrition skin and subcutqneous are in large scope, so the curative effect of SGPISF in repairing sacroiliac decubital necrosis is satisfactory and using double the flaps is the best selection to the large wound.