Kim Sungyeon, Jeon Hong Bae, Kang Dong Hee
Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Cheonan-si 31116, South Korea.
Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, Chungnam, South Korea.
World J Clin Cases. 2025 Aug 6;13(22):107325. doi: 10.12998/wjcc.v13.i22.107325.
Patients with paraplegia are vulnerable to ischial pressure ulcers. Surgical treatments often lead to complications such as seroma and infection, necessitating repeated interventions that increase surgical difficulty. This case report aimed to introduce a novel treatment strategy combining negative pressure wound therapy (NPWT) with a fenestrated Penrose drain to manage refractory seroma in patients with a history of ischial pressure ulcers.
A 63-year-old woman presented with soft tissue defects on the left ischium and right trochanter. After surgical debridement, an inferior gluteal artery perforator (IGAP) flap was used to reconstruct the left ischium. NPWT was applied at a setting of 75 mmHg on postoperative day 3 owing to the development of seroma, combined with a fenestrated Penrose drain to facilitate effective drainage of serous fluid. A 54-year-old man presented with a 4 cm × 2 cm ulcer on the left ischium after previous excision and flap coverage. After thorough debridement, the IGAP flap was elevated, and NPWT with a fenestrated Penrose drain was implemented immediately postoperatively at 75 mmHg to promote drainage. Both patients achieved a stable recovery without complications.
NPWT combined with a fenestrated Penrose drain placement is a promising strategy for addressing refractory seromas in cases of complex pressure ulcers.
截瘫患者易发生坐骨压力性溃疡。手术治疗常导致血清肿和感染等并发症，需要反复干预，增加了手术难度。本病例报告旨在介绍一种将负压伤口治疗（NPWT）与带孔彭罗斯引流管相结合的新型治疗策略，用于治疗有坐骨压力性溃疡病史患者的难治性血清肿。
一名63岁女性，左坐骨和右转子处出现软组织缺损。手术清创后，采用臀下动脉穿支（IGAP）皮瓣重建左坐骨。术后第3天，因出现血清肿，以75 mmHg的压力进行NPWT治疗，并结合带孔彭罗斯引流管以促进浆液有效引流。一名54岁男性，此前切除并皮瓣覆盖后，左坐骨出现一个4 cm×2 cm的溃疡。彻底清创后，掀起IGAP皮瓣，术后立即以75 mmHg的压力进行带孔彭罗斯引流管的NPWT治疗以促进引流。两名患者均实现稳定康复，无并发症发生。
NPWT联合放置带孔彭罗斯引流管是治疗复杂压力性溃疡病例中难治性血清肿的一种有前景的策略。
