Gupta Sandipan, Chattopadhyay Debarati, Agarwal Akhilesh Kumar, Guha Goutam, Bhattacharya Nirjhar, Chumbale Pawan K, Gupta Souradip, Murmu Marang Buru
Department of Plastic Surgery, Medical College, Kolkata, India.
Department of General Surgery, Nilratan Sircar Medical College and Hospital, Kolkata, India.
Asian Spine J. 2014 Jun;8(3):309-14. doi: 10.4184/asj.2014.8.3.309. Epub 2014 Jun 9.
Case series.
To describe paraspinal transposition flap for coverage of sacral soft tissue defects.
Soft tissue defects in the sacral region pose a major challenge to the reconstructive surgeon. Goals of sacral wound reconstruction are to provide a durable skin and soft tissue cover adequate for even large sacral defects; minimize recurrence; and minimize donor site morbidity. Various musculocutaneous and fasciocutanous flaps have been described in the literature.
The flap was applied in 53 patients with sacral soft tissue defects of diverse etiology. Defects ranged in size from small (6 cm×5 cm) to extensive (21 cm×10 cm). The median age of the patients was 58 years (range, 16-78 years).
There was no flap necrosis. Primary closure of donor sites was possible in all the cases. The median follow up of the patients was 33 months (range, 4-84 months). The aesthetic outcomes were acceptable. There has been no recurrence of pressure sores.
The authors conclude that paraspinal transposition flap is suitable for reconstruction of large sacral soft tissue defects with minimum morbidity and excellent long term results.
病例系列。
描述用于覆盖骶部软组织缺损的椎旁转位皮瓣。
骶部区域的软组织缺损给重建外科医生带来了重大挑战。骶部伤口重建的目标是为即使是大的骶部缺损提供持久的皮肤和软组织覆盖;将复发风险降至最低;并将供区并发症降至最低。文献中已描述了各种肌皮瓣和筋膜皮瓣。
该皮瓣应用于53例病因各异的骶部软组织缺损患者。缺损大小从小型(6厘米×5厘米)到广泛型(21厘米×10厘米)不等。患者的中位年龄为58岁(范围16 - 78岁)。
无皮瓣坏死。所有病例的供区均可行一期缝合。患者的中位随访时间为33个月(范围4 - 84个月)。美学效果可接受。未出现压疮复发。
作者得出结论,椎旁转位皮瓣适用于重建大型骶部软组织缺损,并发症最少且长期效果良好。