Department of Orthopedic Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
J Reconstr Microsurg. 2010 Aug;26(6):355-8. doi: 10.1055/s-0030-1249318. Epub 2010 Feb 24.
Among the many difficult problems presented by patients with spinal cord injuries, management of ischial pressure ulcers remains challenging for reconstructive surgeons. This study describes the long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores. Between January 1999 and June 2003, 12 patients with ischial sores were enrolled in this study. All the patients underwent early aggressive surgical debridement followed by surgical reconstruction with a laterally based posterior-thigh fasciocutaneous flap. The follow-up period ranged from 24 months to 97 months (mean, 62 months). All the flaps survived, and there were no partial flap losses. Primary-wound healing occurred in all the cases. In two patients, Grade II ischial pressure sores recurred 24 months and 27 months after the operation. There was no recurrence in the other 10 patients. The posterior-thigh fasciocutaneous pedicled flap was a good method for treating ischial bed sores. This flap could be used to treat recurrences observed after primary bed-sore treatment with other methods. The flap was easy to raise, and it did not cause any donor-site morbidity. The long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores was generally good.
在脊髓损伤患者面临的诸多难题中，坐骨压力性溃疡的处理对重建外科医生来说仍是一个挑战。本研究描述了使用股后外侧筋膜皮瓣治疗坐骨压力性溃疡的长期结果。1999 年 1 月至 2003 年 6 月期间，共有 12 例坐骨溃疡患者纳入本研究。所有患者均接受早期积极的手术清创，随后采用外侧股后外侧筋膜皮瓣进行手术重建。随访时间为 24 个月至 97 个月（平均 62 个月）。所有皮瓣均存活，无部分皮瓣丢失。所有病例均一期愈合。有 2 例患者在术后 24 个月和 27 个月出现 II 级坐骨压力性溃疡复发，其他 10 例患者无复发。股后外侧筋膜皮瓣是治疗坐骨褥疮的一种良好方法。该皮瓣可用于治疗其他方法治疗原发性褥疮后观察到的复发。该皮瓣易于掀起，不会造成供区并发症。使用股后外侧筋膜皮瓣治疗坐骨压力性溃疡的长期结果总体良好。
