Division of Plastic Surgery/Wound Care, St Michael's Hospital, University of Toronto, Toronto, ON, Canada, M5B 1W8.
Int Wound J. 2010 Apr;7(2):103-6. doi: 10.1111/j.1742-481X.2010.00662.x.
This study sought to both assist in the selection of flaps for ischial pressure wound re-construction and to evaluate the overall complication rates associated with re-construction. A retrospective medical record review was conducted for 78 patients following the surgical re-construction of an ischial pressure sore. Records were reviewed for demographics, location of sores, methods of re-construction and flap selection, as well as any complications and recurrences. Seventy-two wounds were re-constructed with an average of 1.4 flaps used per wound. An ischial flap complication rate of 16% was observed in flap follow up, with a recurrence rate of 7% recorded. The vast majority of complications went on to heal with 15% of patients requiring a second re-construction. Our relatively large sample of ischial flaps allowed for a close comparison with previously published work. Both flap selection and site of reconstruction significantly affected the success rates for pressure sore coverage. The overall complication rates by flap and re-constructive site in this review are lower than previously published reports. Our experience with ischial re-construction was extensive enough to suggest a posterior medial thigh fasciocutaneous flap combined with a biceps femoris muscle flap as a first choice in ischial pressure wound re-construction.
本研究旨在协助选择用于坐骨压力性伤口重建的皮瓣，并评估与重建相关的总体并发症发生率。对 78 例接受坐骨压力性溃疡手术重建的患者进行了回顾性病历回顾。记录了人口统计学资料、溃疡位置、重建方法和皮瓣选择，以及任何并发症和复发情况。72 个伤口采用平均每个伤口 1.4 个皮瓣进行重建。在皮瓣随访中观察到坐骨皮瓣并发症发生率为 16%，记录到复发率为 7%。绝大多数并发症得以愈合，15%的患者需要再次重建。我们相对较大的坐骨皮瓣样本允许与以前发表的工作进行密切比较。皮瓣选择和重建部位都显著影响了压疮覆盖的成功率。本研究中皮瓣和重建部位的总体并发症发生率低于以前发表的报告。我们在坐骨重建方面的经验足以表明，在后内侧股筋膜皮瓣联合股二头肌肌瓣作为坐骨压力性伤口重建的首选。
