From the Department of Orthopedics, Xuzhou Central Hospital.
Graduate School, Nanjing University of Chinese Medicine, Nanjing.
Ann Plast Surg. 2021 Jan;86(1):62-66. doi: 10.1097/SAP.0000000000002442.
As a common complication of the long-term bedridden patients, pressure sore is a great challenge for surgeons. The purpose of this study was to explore the surgical method of using a clover-style fasciocutaneous perforator flap raised on the buttocks for the treatment of massive sacral pressure sores and report the clinical outcomes.
The study included 15 patients from January 2015 to June 2017 with an average age of 52.87 years (range, 32-73 years). The size of the sacral pressure sores ranged from 10 cm × 13 cm to 18 cm × 20 cm. The defects were reconstructed using a fasciocutaneous perforator flap raised on the buttocks after debridement and vacuum sealing drainage treatment for 1 to 2 weeks. All the donor areas were sutured directly.
All flaps survived completely; 13 patients achieved healing by primary intention, and the other 2 patients achieved healing by secondary intention. At the mean follow-up period of 20.8 months (range, 12-46 months), the appearance of the flap, including its texture and color, in all patients was satisfactory. No patients had deep infection, necrosis, or shrinkage of the flap during the follow-up period. One patient had a recurrent bedsore during the 2-year follow-up.
The clover-style fasciocutaneous perforator flap is ideal for the reconstruction of massive sacral pressure sores because it is a relatively simple procedure and results in good appearance and function, few complications, and a low recurrence rate.
压疮是长期卧床患者的常见并发症，对外科医生来说是一个巨大的挑战。本研究旨在探讨采用臀部三叶式筋膜皮瓣治疗大面积骶尾部压疮的手术方法，并报告其临床疗效。
本研究纳入了 2015 年 1 月至 2017 年 6 月的 15 例患者，平均年龄 52.87 岁（范围，32-73 岁）。压疮大小为 10 cm×13 cm 至 18 cm×20 cm。清创及负压封闭引流治疗 1-2 周后，采用臀部三叶式筋膜皮瓣修复创面。所有供区均直接缝合。
所有皮瓣均完全存活；13 例患者一期愈合，2 例患者二期愈合。在平均 20.8 个月（范围，12-46 个月）的随访中，所有患者皮瓣的外观、质地和颜色均满意。随访期间无深部感染、皮瓣坏死或收缩。1 例患者在随访 2 年内复发压疮。
三叶式筋膜皮瓣是治疗大面积骶尾部压疮的理想选择，因为该手术方法相对简单，且皮瓣外观和功能良好，并发症少，复发率低。
