Aggarwal A, Sangwan S S, Siwach R C, Batra K M
Postgraduate Department of Orthopaedic Surgery, Paraplegia, Physical Medicine and Rehabilitation, Medical College & Hospital, Rohtak, India.
Spinal Cord. 1996 Jun;34(6):346-50. doi: 10.1038/sc.1996.63.
Surgical management of decubitus ulcers in spinal cord injured patients (SCI) has been considerably improved by the application of muscle, myocutaneous and fasciocutaneous flaps. The goal of the present study was to do a critical analysis of the use of a gluteus maximus island flap for sacral pressure sores in paralysed as well as nonparalysed patients. In a prospective study, 34 patients with sacral pressure sores from grade V to VII were treated by gluteus maximus myocutaneous island flaps. Follow up ranged from 1.8 years to 6.2 years. Results were evaluated according to criteria based on (i) extent of wound dehiscence (ii) flap necrosis (iii) recurrence. Final results were excellent to good in 30 cases (88.3%). Poor results occurred in two patients (5.8%) and recurrence in one (2.9%) due to a major flap necrosis. Postoperative infection and wound dehiscence occurred in two cases each. No systemic complications occurred except for one patient who died from uraemia. The rehabilitation of these patients was improved. The postoperative duration of stay in hospital was from 18 to 32 days (mean: 22.5 days). The majority of the patients were quite pleased with the operation.
肌肉瓣、肌皮瓣和筋膜皮瓣的应用显著改善了脊髓损伤（SCI）患者褥疮的外科治疗。本研究的目的是对臀大肌岛状皮瓣用于瘫痪和非瘫痪患者骶部压疮的情况进行批判性分析。在一项前瞻性研究中，34例骶部V至VII级压疮患者接受了臀大肌肌皮岛状皮瓣治疗。随访时间为1.8年至6.2年。根据以下标准评估结果：（i）伤口裂开程度；（ii）皮瓣坏死；（iii）复发情况。30例（88.3%）患者最终结果为优或良。2例（5.8%）患者结果较差，1例（2.9%）因皮瓣大面积坏死复发。术后感染和伤口裂开各发生2例。除1例死于尿毒症的患者外，未发生全身并发症。这些患者的康复情况得到改善。术后住院时间为18至32天（平均：22.5天）。大多数患者对手术相当满意。
