臀大肌带蒂肌皮瓣结合负压封闭引流技术在褥疮创面修复中应用研究

Application study of gluteus maximus myocutaneous flap combined with vacuum sealing drainage technology in bedsore wound repair

目的:探讨臀大肌带蒂肌皮瓣结合负压封闭引流技术在褥疮创面修复的应用效果。方法:纳入我院2013年2月—2015年2月确诊为骶尾部褥疮合并皮肤软组织缺损的24例患者,应用臀上动脉浅支为蒂的臀大肌带蒂肌皮瓣结合VSD负压封闭引流技术治疗。结果:术后2例皮瓣血运不良,创面延期愈合;1例患者出现皮瓣边缘坏死,换药之后创面肉芽长出,再行2期植皮手术,术后伤口愈合;其余皮瓣均能够成活,创面Ⅰ期愈合;供区的切口均为Ⅰ期愈合;所有患者均进行了为期12个月的随访,6例患者出现了皮瓣移植后的臃肿;其余18例均取得了满意的临床疗效。均在治疗后1个月内出现一定程度的深浅感觉功能障碍,3~6个月感觉逐渐恢复。结论:臀大肌带蒂肌皮瓣结合负压封闭引流技术能较好地修复骶尾部褥疮合并组织皮肤缺损,该方法是一种安全、有效的手术方法。

Objective： To investigate the application effect of gluteus maximus myocutaneous flap combined with vacuum sealing drainage technology in bedsore wound repair. Methods： 24 patients with bedsore wound repair combined with skin and soft tissue defects, diagnosed in our hospital from February 2013 to February 2015 were included and given gluteus maximus myocutaneous flap combined with vacuum sealing drainage treatment. Results： Two patients had bad flap blood supply, and the wounds healing was delayed; one patient had edge flap necrosis after dressing granulation growing and received 2nd skin grafts, wound was healed; other flaps survived wound healing and incision donor sites were healed; All patients underwent a 12-month follow-up, 6 patients were bloated after the transplantation of flap; the rest 18 patients achieved satisfactory clinical efficacy. All patients had certain degree of feeling dysfunction a month after treatment, which disappeared within 3-6 months, and their feeling gradually returned. Conclusion： The gluteus maximus myocutaneous flap combined with vacuum sealing drainage technology could repair bedsore wound repair combined with skin and soft tissue defects, it was a safe and effective surgical method.