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改良臀上菱形筋膜皮瓣在修复骶尾部压疮中的临床应用

[Clinical application of modified upper gluteal rhomboid fasciocutaneous flap in repairing sacrococcygeal pressure sores].

作者信息

Jiang Maohua, Yang Xiaoliang, Wei Bangmin, Li Yinghao

机构信息

Department of Burn and Plastic Surgery, Qingdao Central Hospital, Qingdao Shandong 266042, P R China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Mar;26(3):319-21.

Abstract

OBJECTIVE

To investigate the method and effectiveness of repairing sacrococcygeal pressure sores with modified upper gluteal rhomboid fasciocutaneous flap.

METHODS

Between January 2004 and March 2011, 43 patients with sacrococcygeal pressure sores were treated. There were 25 males and 18 females with an average age of 63 years (range, 38-95 years). The disease duration was 3 months to 2 years and 6 months (mean, 8.5 months). The size of pressure sores ranged from 6 cm x 5 cm to 18 cm x 13 cm. According to the extent and lesion degree of pressure scores, 23 pressure sores were rated as degree III and 20 pressure sores as degree IV. The modified upper gluteal rhomboid flap was designed, one-side upper gluteal fasciocutaneous flaps were transplanted to repair sacrococcygeal pressure sores in 19 cases and two-side flaps in 24 cases. The size of one side flap ranged from 6.5 cm x 4.5 cm to 18.0 cm x 11.5 cm.

RESULTS

Fluid under flap occurred in 1 case and edge necrosis of the flaps in 3 cases at 7 days after operation, which were cured after drainage and dressing change; the other flaps survived, and incisions healed by first intention. All patients were followed up 6 months to 3 years with an average of 11 months. Two patients relapsed at 5 months and 8 months, respectively; the other patients had no recurrence. The color of the flaps was normal, and the appearance and elasticity of the flaps were good.

CONCLUSION

The modified upper gluteal rhomboid fasciocutaneous flap has the advantages of simple design and operation, less injury, and reliable effect in repairing sacrococcygeal pressure sores.

摘要

目的

探讨改良臀上菱形筋膜皮瓣修复骶尾部压疮的方法及疗效。

方法

2004年1月至2011年3月,收治43例骶尾部压疮患者。其中男25例,女18例,平均年龄63岁(38~95岁)。病程3个月至2年6个月,平均8.5个月。压疮面积6 cm×5 cm至18 cm×13 cm。根据压疮程度及病变范围,Ⅲ度压疮23例,Ⅳ度压疮20例。设计改良臀上菱形皮瓣,19例采用单侧臀上筋膜皮瓣移植修复骶尾部压疮,24例采用双侧皮瓣。单侧皮瓣面积6.5 cm×4.5 cm至18.0 cm×11.5 cm。

结果

术后7天,1例皮瓣下积液,3例皮瓣边缘坏死,经引流换药后治愈;其余皮瓣成活,切口一期愈合。所有患者随访6个月至3年,平均11个月。2例分别于术后5个月和8个月复发;其余患者未复发。皮瓣颜色正常,外观及弹性良好。

结论

改良臀上菱形筋膜皮瓣修复骶尾部压疮具有设计及操作简单、损伤小、效果可靠等优点。

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