Ramirez O M, Swartz W M, Futrell J W
Br J Plast Surg. 1987 Jan;40(1):1-10. doi: 10.1016/0007-1226(87)90002-6.
The gluteus maximus muscle and other haemodynamically related structures have been used for the reconstruction of significant defects in the perineum, sacrum, lumbar area and hip in 35 patients. The preservation of muscle function was achieved in all of 20 ambulatory patients and documented by gait analysis, muscle strength testing and EMG studies. Dye injection studies of the first perforating artery, inferior gluteal artery and superior gluteal artery led to the design of new flaps based on this arterial system. They include: medial advancements with extension above the sacrum, lateral advancements, lower gluteus advancements, the tensor fasciae latae gluteal extension and modifications of the gluteal thigh flap. These findings significantly increase our ability to close difficult wounds within the perineal, sacral, lumbar and trochanteric regions.
35例患者中，臀大肌及其他血流动力学相关结构已用于会阴、骶骨、腰椎区域和髋部严重缺损的重建。20例能行走的患者均实现了肌肉功能的保留，并通过步态分析、肌力测试和肌电图研究得以证实。对第一穿动脉、臀下动脉和臀上动脉进行染料注射研究后，设计出了基于该动脉系统的新皮瓣。它们包括：向内侧推进并延伸至骶骨上方、向外侧推进、臀下部推进、阔筋膜张肌臀延伸以及臀股皮瓣的改良。这些发现显著提高了我们闭合会阴、骶骨、腰椎和转子区域难愈伤口的能力。
