随机模式斧形皮瓣作为治疗压疮的重建工具：36 例患者的临床经验。
Random pattern hatchet flap as a reconstructive tool in the treatment of pressure sores: clinical experience with 36 patients.
机构信息
University of Anbar, Anbar, Iraq.
University of Baghdad, Iraq.
出版信息
Ann R Coll Surg Engl. 2021 May;103(5):374-379. doi: 10.1308/rcsann.2020.7077. Epub 2021 Mar 19.
INTRODUCTION
Pressure sores represent a reconstructive challenge, and the high recurrence rate and need for reoperations should always be considered. Sacrifice of muscle and fascia in primary reconstruction may compromise options for future repairs. The objective of this study was to evaluate the reliability of muscle- and fascia-sparing random pattern hatchet flap reconstruction of pressure sores in different body regions.
METHODS
From November 2017 to December 2019, 36 participants with grade III and IV pressure sores underwent random pattern hatchet flap reconstruction. Early postoperative complications and flap survival were evaluated in follow up for 6-12 months.
RESULTS
Thirty-six participants with an age range of 15 to 67 years who presented with pressure sores (13 sacral, 12 ischial, 10 trochanteric, and 1 scapular) underwent surgery. Complete healing of sores was observed within 21 days of surgery in 32 cases and within 30 days for the remaining four cases. Postoperative complications (11.2%) were recorded in only four participants: two experienced partial wound dehiscence, one seroma developed in a trochanteric case, and there was one infection in a sacral sore.
CONCLUSIONS
Random pattern hatchet flap is a reliable tool that results in minimal complications for treatment of pressure sores of limited dimensions.
简介
压疮是一种具有挑战性的重建问题，其高复发率和需要再次手术的情况应始终考虑在内。在初次重建中牺牲肌肉和筋膜可能会影响未来修复的选择。本研究的目的是评估不同身体部位的保留肌肉和筋膜的随意皮瓣战斧皮瓣重建压疮的可靠性。
方法
2017 年 11 月至 2019 年 12 月，36 名 III 级和 IV 级压疮患者接受了随意皮瓣战斧皮瓣重建。在 6-12 个月的随访中评估了早期术后并发症和皮瓣存活率。
结果
36 名年龄在 15 至 67 岁之间的参与者，患有压疮（13 例骶骨，12 例坐骨，10 例转子间，1 例肩胛）接受了手术。32 例患者在术后 21 天内观察到伤口完全愈合，其余 4 例患者在术后 30 天内愈合。仅 4 名患者记录了术后并发症（11.2%）：2 名患者出现部分伤口裂开，1 名转子间病例出现血清肿，1 名骶骨压疮感染。
结论
随意皮瓣战斧皮瓣是一种可靠的工具，可治疗有限尺寸的压疮，并发症最小。
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