Samsung Medical Center, Department of Plastic Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2011 Jun;64(6):790-5. doi: 10.1016/j.bjps.2010.09.020. Epub 2010 Dec 8.
Many procedures have been proposed for the treatment of sacral sores, and bilobed flaps are widely used to reconstruct defects of the lower third of the nose. This retrospective study was conducted to evaluate our experiences of bilobed flaps based on parasacral perforators, for the treatment of sacral sores.
Twelve patients, six males and six females, aged 21-74 years (mean age: 51.08 years), with a sacral sore were treated with a bilobed flap at our institution from February 2007 to November 2009. Sacral sores were treated by en bloc excision and defects were closed using a bilobed flap in each case. Flaps were designed using parasacral perforators after considering pocket locations. The average postoperative follow-up duration was 16 months.
Primary wound healing was achieved in all patients. Large defects left after excision were easily closed using bilobed flaps, which provided tensionless wound closure. The postoperative courses were uneventful in all 12 cases, and no patient experienced recurrence.
The use of a perforator-based bilobed flap enables regional reconstruction using well-vascularised tissues, and provides satisfactory and aesthetic results in sore patients. Furthermore, rerotation is possible in the event of sore recurrence. Accordingly, we consider the perforator-based bilobed flap to be a useful and additional tool for the treatment of pressure sores.
许多方法被提出用于治疗骶尾部溃疡，双叶皮瓣被广泛用于重建鼻下部的缺损。本回顾性研究旨在评估基于骶旁穿支的双叶皮瓣在治疗骶尾部溃疡中的应用经验。
2007 年 2 月至 2009 年 11 月，我院对 12 例骶尾部溃疡患者（男 6 例，女 6 例；年龄 21-74 岁，平均 51.08 岁）采用双叶皮瓣进行治疗。所有患者均采用整块切除的方法治疗骶尾部溃疡，并用双叶皮瓣闭合缺损。皮瓣设计时考虑了袋状结构的位置，并利用骶旁穿支。所有患者的平均术后随访时间为 16 个月。
所有患者均获得一期愈合。双叶皮瓣可轻松闭合切除后遗留的较大缺损，且皮瓣张力小。12 例患者的术后过程均顺利，无患者复发。
基于穿支的双叶皮瓣可利用血供良好的组织进行区域性重建，为溃疡患者提供满意且美观的效果。此外，若溃疡复发，可进行皮瓣再旋转。因此，我们认为基于穿支的双叶皮瓣是治疗压力性溃疡的一种有用且额外的工具。
