床边A-T皮瓣联合Burow's楔形皮瓣在老年患者小腿前区溃疡型压疮创面中的应用

目的探讨床边A-T皮瓣联合Burow's楔形皮瓣修复小腿胫前压疮创面的临床疗效.方法选择2014年3月至2017年8月老年患者小腿前区溃疡型压疮31例,缺损面积1.5cm×3.5cm^3.5cm×5.5cm.所有患者术前均给予创面负压引流创面床准备,负压后在床边于创面一端设计横切线形成A-T皮瓣同时在创面对侧的横切线延长处末端切除一个Burow's三角,形成Burow's楔形推进皮瓣修复治疗压疮创面.结果31例皮瓣全部存活,有6例出现术后感染,经换药后愈合,术后平均随访6个月(2~12个月),所有患者未见压疮复发.结论床边应用AT皮瓣联合Burow's楔形皮瓣修复老年患者小腿前区压疮是一种的有效治疗方法,疗效满意.

Objective To evaluate the clinical efficacy of bedside A-T flap combined with Burow’s wedge flap in the repair of calf wound before calf.Methods Thirty-one patients with ulcerative pressure ulcers in the anterior region of the calf from March 2014 to August 2017 were selected.The defect area was 1.5cm×3.5cm^3.5cm×5.5 cm.All patients were given a vacuum-invasive drainage wrap preparation before operation.After negative pressure,a transection line was formed at the end of the bed to form an AT flap,and a Burow's triangle was cut at the end of the transverse line of the incision side to form a Burow's wedge.The flap was pushed to repair the pressure ulcer wound.Results All 31 flaps survived.Six patients developed postoperative infection.They were healed after dressing change.The average follow-up period was 6 months(2~12months).All patients had no recurrence of pressure ulcers.Conclusion The combination of AT flap and Burow’s wedge flap in the treatment of anterior calf pressure in elderly patients is an effective way to obtain satisfactory results.