Lemaire Vincent, Boulanger Kevin, Heymans Oliver
Department of Plastic Surgery, University Hospital, Liege, Belgium.
Ann Plast Surg. 2008 Jun;60(6):631-4. doi: 10.1097/SAP.0b013e31812c1465.
Management of pressure sores still represents a major challenge in plastic surgery practice due to recurrence. The surgeon may have to face multiple or recurrent pressure ulcerations without any local flap left. In this very limited indication, free flap surgery appears to be a useful adjunct in the surgical treatment. We reviewed our charts looking for patients operated for a pressure sore of the sacral, ischial, or trochanteric region. We found 88 consecutive patients representing 108 different pressure sores and 141 flap procedures. Among these patients, 6 presented large sores that could not be covered with a pedicled flap and benefited from free flap surgery (4.2% of all procedures). Stable coverage was achieved in 80% of these patients after a mean follow-up of 32 months. Comparison between pedicled and free flaps groups showed a trend in the latest concerning the presence of diabetes, incontinence, paraplegia, and male sex.
由于压疮会复发，其治疗在整形外科实践中仍然是一项重大挑战。外科医生可能不得不面对多处或复发性压疮，而没有可用的局部皮瓣。在这种非常有限的适应症情况下，游离皮瓣手术似乎是手术治疗中的一种有用辅助手段。我们查阅了病历，寻找因骶骨、坐骨或转子区压疮而接受手术的患者。我们发现了88例连续患者，代表108处不同的压疮和141次皮瓣手术。在这些患者中，有6例出现了无法用带蒂皮瓣覆盖的大溃疡，并受益于游离皮瓣手术（占所有手术的4.2%）。这些患者在平均随访32个月后，80%实现了稳定覆盖。带蒂皮瓣组和游离皮瓣组之间的比较显示，在糖尿病、失禁、截瘫和男性方面，游离皮瓣组有一定趋势。
