Ishikawa Shoichi, Takaoka Satomi, Arai Kiyohito, Ichioka Shigeru
Department of Plastic, Reconstructive and Aesthetic Surgery, Saitama Medical University, Saitama, Japan.
Department of Cardiology, Saiseikai Kurihashi Hospital, Saitama, Japan.
Plast Reconstr Surg Glob Open. 2021 Nov 29;9(11):e3971. doi: 10.1097/GOX.0000000000003971. eCollection 2021 Nov.
We experienced a case of a sacral pressure ulcer complicated with Leriche syndrome, an aortoiliac artery occlusion that has not been previously reported. In this case, the abdominal aorta below the bifurcation of the renal arteries into the bilateral common iliac arteries was occluded, and wound healing was delayed. Therefore, endovascular treatment was used for managing this condition, and wound healing was accelerated. Then, reconstructive surgery with a local flap was performed, and wound healing was achieved. In the case of delayed healing of buttock pressure ulcers, it is important to evaluate the blood flow in the iliac artery as well as the infection and nutritional status of the wound. In addition, after endovascular treatment, blood flow in the local flap is a matter of concern. If the wound healing is good, and imaging confirms that there is no restenosis at the endovascular treatment site and the perforator of the flap, reconstructive surgery can be performed safely.
我们遇到了一例骶部压疮合并勒里什综合征（一种此前未被报道过的主髂动脉闭塞）的病例。在该病例中，肾动脉分叉下方至双侧髂总动脉的腹主动脉发生了闭塞，导致伤口愈合延迟。因此，采用了血管内治疗来处理这种情况，伤口愈合加速。随后，进行了局部皮瓣重建手术，实现了伤口愈合。对于臀部压疮延迟愈合的情况，评估髂动脉血流以及伤口的感染和营养状况很重要。此外，血管内治疗后，局部皮瓣的血流情况也值得关注。如果伤口愈合良好，且影像学检查确认血管内治疗部位和皮瓣穿支处无再狭窄，就可以安全地进行重建手术。
