Khurram M F, Khan A H, Ahmad I, Nanda M, Masoodi Z
MCh(Plast Surg), Assistant Professor, Post-Graduate Department of Burns, Plastic and Reconstructive Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, India.
MCh(Plast Surg), Professor, Post-Graduate Department of Burns, Plastic and Reconstructive Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, India.
J Wound Care. 2013 Dec;22(12):699-702, 704-5. doi: 10.12968/jowc.2013.22.12.699.
To study the feasibility and reliability of the superior gluteal artery perforator (SGAP) flap for the reconstruction of sacral pressure ulcers.
A prospective study was conducted between 2009 and 2012 where a total of 15 patients with sacral pressure ulcers underwent reconstructive surgery with an islanded pedicled SGAP flap. Success of the flap reconstruction and primary healing were defined as a healed wound within 30 days of the procedure. Reconstructive failure was defined as those cases that resulted in a non-healed wound, thereafter.
Of the 15 patients in the evaluation, 12 were male and 3 were female. Eleven patients were paraplegic, 3 were ambulatory and one was quadriplegic. All reconstructed flaps survived completely with no mortality or major donor site complications. Three patients had a minor infection and wound dehiscence that healed spontaneously. All wounds healed within 30 days of surgery following local wound care and culture-sensitive antibiotics. No recurrence of the pressure ulcer occurred during follow-up. The non-paraplegic patients did not develop gait disturbances following the surgery.
These observations suggest that the islanded pedicled SGAP fasciocutaneous flap is a relatively easy flap to raise, with good reliability and minimal complications, and is therefore highly recommended for the reconstruction of the sacral pressure ulcer.
There were no external sources of funding for this study. The authors have no conflicts of interest to declare.
研究臀上动脉穿支(SGAP)皮瓣修复骶尾部压疮的可行性和可靠性。
2009年至2012年进行了一项前瞻性研究,共有15例骶尾部压疮患者接受了带蒂岛状SGAP皮瓣重建手术。皮瓣重建成功和一期愈合定义为术后30天内伤口愈合。重建失败定义为术后伤口未愈合的病例。
在评估的15例患者中,男性12例,女性3例。11例为截瘫患者,3例可行走,1例为四肢瘫患者。所有重建皮瓣均完全存活,无死亡或主要供区并发症。3例患者出现轻度感染和伤口裂开,均自行愈合。经局部伤口护理和使用敏感抗生素后,所有伤口均在术后30天内愈合。随访期间压疮无复发。非截瘫患者术后未出现步态障碍。
这些观察结果表明,带蒂岛状SGAP筋膜皮瓣相对容易切取,可靠性好,并发症少,因此强烈推荐用于骶尾部压疮的重建。
本研究无外部资金来源。作者声明无利益冲突。