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[股二头肌长头肌瓣联合大腿后外侧半V形筋膜皮瓣修复坐骨结节压疮]

[Repair of pressure sores over ischial tuberosity with long head of biceps femoris muscle flap combined with semi-V posterior thigh fasciocutaneous flap].

作者信息

Hai Heng-lin, Shen Chuan-an, Chai Jia-ke, Li Hua-tao

机构信息

Burns Institute, the First Affiliated Hospital to the PLA General Hospital, Beijing, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2012 Feb;28(1):57-9.

Abstract

OBJECTIVE

To explore the clinical effect of transplantation of the long head of biceps femoris muscle flap in combination with semi-V posterior thigh fasciocutaneous flap for repair of pressure sores over ischial tuberosity.

METHODS

Eight patients with 10 deep pressure sores over ischial tuberosity were admitted to the First Affiliated Hospital to the PLA General Hospital and the 98th Hospital of PLA from April 2004 to June 2010. The wounds measured from 2 cm × 2 cm to 6 cm × 4 cm were covered with the long head of biceps femoris muscle flap and semi-V posterior thigh fasciocutaneous flap (ranged from 10 cm × 6 cm to 13 cm × 8 cm). The condition of flaps was observed and followed up for a long time.

RESULTS

All flaps survived. Nine wounds healed by first intention. Subcutaneous accumulation of fluids occurred in one wound with formation of a sinus at drainage site, and it healed after dressing change for 25 days. Patients were followed up for 7 to 34 months. Sore recurred in one patient 9 months after surgery, and it was successfully repaired with the same flap for the second time. Flaps in the other 7 patients appeared satisfactory with soft texture and without ulceration.

CONCLUSIONS

This combined flap is easy in formation and transfer, and it causes little side injury with good resistance against pressure. It is a new method for repair of pressure sore over sacral region.

摘要

目的

探讨股二头肌长头肌瓣联合股后外侧半V形筋膜皮瓣移植修复坐骨结节压疮的临床效果。

方法

2004年4月至2010年6月,解放军总医院第一附属医院及解放军第九十八医院收治8例患者,共10处坐骨结节深度压疮。创面大小为2 cm×2 cm至6 cm×4 cm,采用股二头肌长头肌瓣联合股后外侧半V形筋膜皮瓣(大小为10 cm×6 cm至13 cm×8 cm)覆盖。观察皮瓣情况并进行长期随访。

结果

所有皮瓣均成活。9处创面一期愈合。1处创面出现皮下积液,引流部位形成窦道,经换药25天后愈合。患者随访7至34个月。1例患者术后9个月压疮复发,再次采用相同皮瓣成功修复。其余7例患者皮瓣质地柔软,无溃疡,外观满意。

结论

该联合皮瓣制作及转移简便,对供区损伤小,抗压能力强,是修复骶尾部压疮的一种新方法。

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