Hallock Geoffrey G
Division of Plastic Surgery, The Lehigh Valley Hospitals, Allentown, PA, USA.
Ann Plast Surg. 2006 May;56(5):540-2. doi: 10.1097/01.sap.0000210512.81988.2b.
Recidivism after flap coverage of ischial and trochanteric pressure sores is predictably common. Available local flap options are limited in number and must be cautiously preserved as long as possible for these patients who are destined to have a lifelong vulnerability for recurrence. Muscle perforator flaps have been introduced as another set of alternatives to solve this conundrum. Since the posteromedial thigh often has been previously unviolated by the usual workhorse flaps selected for this problem, the adductor perforator flap will then usually still be available as an important "backup" option. If designed as a propeller flap, this version after rotation will cover the defect and simultaneously allow direct donor-site closure to avoid the need for a skin graft.
坐骨和转子压疮皮瓣覆盖术后复发很常见,这在意料之中。对于这些注定终生易复发的患者,可用的局部皮瓣选择数量有限,必须尽可能谨慎地保留。肌肉穿支皮瓣已作为另一组替代方案被引入以解决这一难题。由于大腿后内侧通常未被此前针对该问题选择的常用主力皮瓣累及,因此内收肌穿支皮瓣通常仍可作为重要的“备用”选择。如果设计为推进皮瓣,旋转后的这种皮瓣将覆盖缺损,同时可直接闭合供区,避免植皮的需要。