Jiao Xiangong, Cui Chunxiao, Ng Sally Kiu-Huen, Jiang Zhangjia, Tu Chihui, Zhou Jiemin, Lu Xiandong, Ouyang Xianwen, Luo Tong, Li Ke, Zhang Yixin
Plastic, Reconstructive and Burn Centre, Liuyang People's Hospital, 49 Renmin Middle Road, Liuyang 410300, Hunan, China.
ENT Institute, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai 200011, China.
Burns Trauma. 2020 Dec 12;8:tkaa012. doi: 10.1093/burnst/tkaa012. eCollection 2020.
Sacral pressure ulcers are associated with high morbidity and, in some cases, result in mortality from severe sepsis. Local flaps are frequently used for reconstruction of stage III and IV pressure ulcers. An ideal flap should be simple to design, have a reliable vascular supply and minimal donor site morbidity. Our study evaluates the use of a bilobed flap based on the superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery to reconstruct the sacral pressure ulcer.
We performed a retrospective analysis of paraplegic patients with sacral pressure ulcers treated with our bilobed flaps from January 2015 to December 2019. A description of our management, operative protocol, outcome and complications is outlined. Seven paraplegic patients (6 male, 1 female; average age 53.1 years) with sacral pressure ulcers were treated with our bilobed flap based on the superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery. The average size of the pressure ulcers was 7 × 5 cm (range 6.2 × 4.5 cm to 11 × 10 cm). All 7 flaps survived. The patients were followed up for 12 months without significant complications, such as flap necrosis or recurrence.
The superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery reliably supplies the bilobed flap. The superior cluneal nerve can be included in the design. The technique is simple and reliable. It should be included in the reconstructive algorithm for the management of sacral pressure ulcers.
骶骨压疮与高发病率相关，在某些情况下，会导致严重脓毒症死亡。局部皮瓣常用于Ⅲ期和Ⅳ期压疮的修复。理想的皮瓣应设计简单，血供可靠，供区并发症最少。我们的研究评估了基于臀上动脉浅支或第四腰动脉后支的双叶皮瓣用于修复骶骨压疮的效果。
我们对2015年1月至2019年12月期间接受双叶皮瓣治疗的骶骨压疮截瘫患者进行了回顾性分析。概述了我们的治疗方法、手术方案、结果和并发症。7例骶骨压疮截瘫患者（6例男性，1例女性；平均年龄53.1岁）接受了基于臀上动脉浅支或第四腰动脉后支的双叶皮瓣治疗。压疮平均大小为7×5cm（范围6.2×4.5cm至11×10cm）。所有7个皮瓣均存活。患者随访12个月，无明显并发症，如皮瓣坏死或复发。
臀上动脉浅支或第四腰动脉后支能可靠地为双叶皮瓣供血。设计中可包含臀上皮神经。该技术简单可靠。应将其纳入骶骨压疮治疗的重建方案中。
