Poirier P, Madezo P, Perrouin-Verbe B, Hepner-Lavergne D, Pannier M, Bainvel J V
Clinique Chirurgicale Orthopédique, Hôtel-Dieu, CHU Nantes.
Ann Chir Plast Esthet. 1994 Aug;39(4):464-8.
Authors report their experience with the V-Y advancement flap in the coverage of trochanteric pressure sores. Nine flaps have been performed concerning 7 patients. Trochanteric sores in paraplegia or tetraplegia may lead to suppurative arthritis of the hip, with a risk of anaerobic infection and acute septicaemia. The treatment has to be as complete as possible. The trochanteric sore is debrided, with special attention given to removing all necrotic material, the surrounding bursa, and the bony prominence of the greater trochanter. The debrided trochanteric region is then covered by a well-vascularized and thick tissue. We observed only one complication at the donor site which can be closed primarily by this technique. The V-Y advancement technique is a new, simple and safe design of tensor fasciae latae flap. The defect is covered by the thicker and the best vascularized portion of the musculo-cutaneous flap. It allows preservation of other donor sites of the gluteal region to cover other sores, which are often associated.
作者报告了他们使用V-Y推进皮瓣覆盖转子压疮的经验。共对7例患者实施了9次皮瓣手术。截瘫或四肢瘫患者的转子压疮可能导致髋关节化脓性关节炎，存在厌氧菌感染和急性败血症的风险。治疗必须尽可能彻底。对转子压疮进行清创，特别注意清除所有坏死物质、周围的滑囊以及大转子的骨突。然后用血管丰富且厚实的组织覆盖清创后的转子区域。我们在供区仅观察到1例并发症，该技术可一期闭合供区。V-Y推进技术是阔筋膜张肌皮瓣一种新的、简单且安全的术式。缺损由肌皮瓣较厚且血供最佳的部分覆盖。它能保留臀区的其他供区以覆盖其他常常并发的压疮。
