摘要
目的探讨臀上部改良菱形筋膜皮瓣修复骶尾部褥疮的方法及疗效。方法 2004年1月-2011年3月,收治骶尾部褥疮43例。男25例,女18例;年龄38～95岁,平均63岁。褥疮发生时间3个月～2年6个月,平均8.5个月。褥疮范围6 cm×5 cm～18 cm×13 cm。按褥疮范围及病变程度分度:Ⅲ度23例,Ⅳ度20例。采用改良菱形皮瓣设计方法,应用单侧(19例)或双侧(24例)臀上部筋膜皮瓣移位修复。一侧皮瓣切取范围为6.5 cm×4.5 cm～18.0 cm×11.5 cm。结果术后7 d发生皮瓣下积液1例,皮瓣边缘部分坏死3例,经引流、换药处理后皮瓣成活;其余皮瓣均顺利成活,切口均Ⅰ期愈合。患者术后均获随访,随访时间6个月～3年,平均11个月。2例分别于术后5个月和8个月褥疮复发;其余患者均无复发,皮瓣颜色正常,外观及弹性良好。结论采用臀上部改良菱形筋膜皮瓣修复骶尾部褥疮具有设计及操作相对简便、手术损伤小的优点,效果可靠。
Objective To investigate the method and effectiveness of repairing sacrococcygeal pressure sores with modified upper gluteal rhomboid fasciocutaneous flap.Methods Between January 2004 and March 2011,43 patients with sacrococcygeal pressure sores were treated.There were 25 males and 18 females with an average age of 63 years（range,38-95 years）.The disease duration was 3 months to 2 years and 6 months（mean,8.5 months）.The size of pressure sores ranged from 6 cm × 5 cm to 18 cm × 13 cm.According to the extent and lesion degree of pressure scores,23 pressure sores were rated as degree III and 20 pressure sores as degree IV.The modified upper gluteal rhomboid flap was designed,one-side upper gluteal fasciocutaneous flaps were transplanted to repair sacrococcygeal pressure sores in 19 cases and two-side flaps in 24 cases.The size of one side flap ranged from 6.5 cm × 4.5 cm to 18.0 cm × 11.5 cm.Results Fluid under flap occurred in 1 case and edge necrosis of the flaps in 3 cases at 7 days after operation,which were cured after drainage and dressing change;the other flaps survived,and incisions healed by first intention.All patients were followed up 6 months to 3 years with an average of 11 months.Two patients relapsed at 5 months and 8 months,respectively;the other patients had no recurrence.The color of the flaps was normal,and the appearance and elasticity of the flaps were good.Conclusion The modified upper gluteal rhomboid fasciocutaneous flap has the advantages of simple design and operation,less injury,and reliable effect in repairing sacrococcygeal pressure sores.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2012年第3期319-321,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
臀上部菱形筋膜皮瓣
骶尾部褥疮
创面修复
Upper gluteal rhomboid fasciocutaneous flap Sacrococcygeal pressure sore Wound repair
作者简介
通讯作者：姜茂华，副主任医师，研究方向：慢性创面治疗，E—mail：sdqdyxl@sina．com
