Shi C S, Tang X J, Wang D L, Wei Z R, Wang B, Wu B H, Liu Z Y
Department of Burns and Plastic Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China.
Zhonghua Shao Shang Za Zhi. 2019 May 20;35(5):367-370. doi: 10.3760/cma.j.issn.1009-2587.2019.05.008.
To explore the clinical effects of superior gluteal artery perforator island flap in repair of sacral pressure ulcer. From May 2012 to May 2017, 20 patients with sacral pressure ulcers (14 males and 6 females, aged 27 to 67 years) were admitted to our department. According to the consensus staging system of National Pressure Ulcer Advisory Panel in 2016, 6 cases were in 3 stages, 14 cases were in 4 stages, with the area of pressure ulcers ranging from 5.0 cm×4.0 cm to 10.0 cm×8.0 cm. After debridement and vacuum sealing drainage, the superior gluteal artery perforator island flaps were used to repair the pressure wounds, with the area of flaps ranging from 6 cm×5 cm to 13 cm×8 cm. The donor sites were sutured directly. The survival of flaps after operation, the healing of wounds, and the follow-up of patients were observed. After surgery, flaps of 20 patients survived well without reoperation. The length of hospital stay of patients was 20 to 40 days, with an average of 25 days. Eighteen patients were followed up for 6 to 24 months, with an average of 12.2 months. The flaps were in good shape and elastic recovery. There were no complications such as seroma or hematoma in the donor sites. Both the patients and family members expressed satisfaction with the shape and texture of the flap and shape of hip. The superior gluteal artery perforator island flap is reliable in blood supply and easy to rotate. The flap can carry a little muscle to increase the anti-infective ability. Moreover, the donor site can be directly sutured with slight damage. Thus, it is one of the good methods for repairing sacral pressure ulcers.
探讨臀上动脉穿支岛状皮瓣修复骶尾部压疮的临床效果。2012年5月至2017年5月，我科收治20例骶尾部压疮患者（男14例，女6例，年龄27～67岁）。根据2016年美国国家压疮咨询委员会的共识分期系统，3期6例，4期14例，压疮面积5.0 cm×4.0 cm至10.0 cm×8.0 cm。清创及负压封闭引流后，采用臀上动脉穿支岛状皮瓣修复压疮创面，皮瓣面积6 cm×5 cm至13 cm×8 cm。供区直接缝合。观察术后皮瓣存活情况、创面愈合情况及患者随访情况。术后20例患者皮瓣均存活良好，无需再次手术。患者住院时间20～40天，平均25天。18例患者随访6～24个月，平均12.2个月。皮瓣外形良好，弹性恢复。供区无血清肿、血肿等并发症。患者及家属对皮瓣外形、质地及臀部外形均表示满意。臀上动脉穿支岛状皮瓣血供可靠，旋转容易。皮瓣可携带少许肌肉以增强抗感染能力。而且，供区损伤小，可直接缝合。因此，是修复骶尾部压疮的良好方法之一。
