Ellabban Mohamed A, Wyckman Alexander, Abdelrahman Islam, Steinvall Ingrid, Elmasry Moustafa
Plastic and Reconstructive Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt.
Faculty of Medicine, Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Plast Reconstr Surg Glob Open. 2021 Jan 26;9(1):e3376. doi: 10.1097/GOX.0000000000003376. eCollection 2021 Jan.
The reconstruction of complex tissue defects in the lumbar and gluteal areas is a surgical challenge. The use of freestyle perforator-based flaps has gained popularity in the reconstruction of these defects due to several advantages: versatility, minimal donor-site morbidity, and tension-free closure. The present study reports the outcome of using a dual coverage of lumbar and gluteal defects with a gluteus maximus rotation flap as a deep layer and a freestyle propeller perforator-based flap as a superficial layer.
A retrospective analysis of 18 patients who had a dual coverage of complex wounds of the lumbar and the gluteal areas was conducted. Different propeller flaps were used as superior gluteal artery perforator flap (SGAP), inferior gluteal artery perforator flap (IGAP), and posterior thigh perforator flap (PTP).
The study included 15 men and 3 women. The mean age was 26.3 years. The causes of the defects were: pressure ulcers in 14 patients and post-traumatic in 4 patients. A total of 28 freestyle flaps was used: 11 patients had 1 flap, 4 had 2 flaps, and 3 had 3 flaps. The mean postoperative follow-up was 12.2 months. The complications registered in the medical records were venous congestion in 2 patients, partial flap necrosis in 2 patients, and wound dehiscence in 1 patient.
A freestyle propeller perforator-based flap combined with a gluteus maximus muscle flap is a solution that provides well-padding over bony prominence with a low complication rate. However, a long-term follow-up is needed to verify these results.
腰臀区域复杂组织缺损的重建是一项外科挑战。基于随意型穿支皮瓣的应用因其多种优势在这些缺损的重建中越来越受欢迎：多功能性、供区并发症少以及无张力缝合。本研究报告了采用臀大肌旋转皮瓣作为深层、随意型推进穿支皮瓣作为浅层对腰臀缺损进行双重覆盖的结果。
对18例腰臀区域复杂伤口进行双重覆盖的患者进行回顾性分析。使用了不同的推进皮瓣，如臀上动脉穿支皮瓣（SGAP）、臀下动脉穿支皮瓣（IGAP）和大腿后穿支皮瓣（PTP）。
该研究包括15名男性和3名女性。平均年龄为26.3岁。缺损原因：14例为压疮，4例为创伤后。共使用了28个随意型皮瓣：11例患者使用1个皮瓣，4例使用2个皮瓣，3例使用3个皮瓣。术后平均随访12.2个月。病历记录的并发症包括2例静脉淤血、2例部分皮瓣坏死和1例伤口裂开。
随意型推进穿支皮瓣联合臀大肌肌皮瓣是一种解决方案，可在骨隆突处提供良好的填充，并发症发生率低。然而，需要长期随访来验证这些结果。
