Moullot P, Philandrianos C, Casanova D
Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 5, France.
Service de chirurgie plastique, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
Ann Chir Plast Esthet. 2014 Oct;59(5):368-72. doi: 10.1016/j.anplas.2013.06.004. Epub 2013 Aug 9.
Ischial pressure sores, common in paraplegic patient, are the most difficult to treat, and poor prognosis associated with a high rate of postoperative recurrence. Many surgical techniques by muscular or myocutaneous flap coverage have been described. We report an original use of a fasciocutaneous pedicled anterolateral thigh (ALTp) flap for coverage of an ischial pressure sore combined with a trochanteric pressure sore, exceeded beyond any conventional therapeutic solution. A 45-year-old paraplegic patient suffered from a trochanteric and ischial pressure sore, which had already received coverage by a muscular flap of biceps femoris and gluteus maximus. At 1 year, the result is satisfactory, with good coverage without recurrence. The fasciocutaneous ALTp flap can be a solution to cover recurrent ischial pressure sores beyond conventional methods.
坐骨压力性溃疡在截瘫患者中很常见,是最难治疗的,且预后不佳,术后复发率高。已经描述了许多通过肌肉或肌皮瓣覆盖的手术技术。我们报告了一种带蒂股前外侧筋膜皮瓣(ALTp)的创新应用,用于覆盖坐骨压力性溃疡合并转子压力性溃疡,超越了任何传统治疗方法。一名45岁的截瘫患者患有转子和坐骨压力性溃疡,之前已用股二头肌和臀大肌肌瓣覆盖。1年后,结果令人满意,覆盖良好且无复发。带蒂股前外侧筋膜皮瓣可以成为一种超越传统方法覆盖复发性坐骨压力性溃疡的解决方案。