翻转臀大肌-脂肪筋膜瓣在修复骶尾部褥疮中应用.docVIP

翻转臀大肌-脂肪筋膜瓣在修复骶尾部褥疮中应用[摘要]目的:探讨臀大肌-脂肪筋膜瓣在修复骶尾部褥疮中的应用效果。方法:自2007年8月～2010年1月,应用臀大肌-脂肪筋膜瓣用于修复骶尾部褥疮处腔隙18例,该复合组织瓣大小为5cm×6cm～7cm×8cm,然后拉拢两侧创缘闭合创面。结果:本组18例中,16例I期愈合,1例发生感染,1例血肿,均予换药后愈合,复发率5.6%。结论:臀大肌-脂肪筋膜瓣血供丰富,易成活,应用该翻转组织瓣可消灭创面处死腔,可有效防止术后褥疮复发。 [关键词]臀大肌-脂肪筋膜瓣;褥疮;修复 [中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2010)10-1421-03 Application of gluteus maximus muscle-adipofascial turnover flap in the repairment of sacrococcygeal decubitus ulcers LIANG Wei-zhong1,ZHAO Zuo-jun1,AI Hong-mei1,WANG Cong-feng1,YAN Ying-jun1,ZHOU Zheng2 (1.Department of Plastic Surgery,Beijing Meitan General Hospital,Beijing 100028,China;2. Department of General Surgery,Beijing Meitan General Hospital,Beijing 100028,China) Abstract:ObjectiveTo study the clinical effect of gluteus maximus muscle-adipofascial turnover flap in the treatment of sacrococcygeal decubitus ulcers.MethodsFrom August 2007 to January 2010,18 cases of sacrococcygeal decubitus ulcers were repaired by gluteus maximus muscle-adipofascial turnover flap. The area of flaps ranged from 5cm×6cm to 7cm×8cm. The wound is then closed with direct polymerizing suture.ResultsOverall, 88% of the flaps (16 of 18) healed primarily.Two patients had early postoperative complications, including wound infection and hematoma. All of these wounds healed with dressing change.Recurrence rate of the study is 5.6 percent.ConclusionGluteus maximus muscle-adipofascial turnover flap with rich blood supply and high survival percent was a high efficiency approach for filling dead space in repairing sacrococcygeal decubitus ulcers. This method has effect on preventing recurrence of decubitus ulcers after operation. Key words:gluteus maximus muscle-adipofascial flap;decubitus ulcers;repair 骶尾部复杂褥疮常伴有深部肌肉的损害而在清创后形成空腔,应用软组织瓣覆盖骨性突起并有效地消灭该腔隙是防止褥疮复发的关键。同时,由于该类患者健康状况常较差,应用微创且有效的方法修复褥疮成为必要。我科自2007年8月～2010年1月,将翻转臀大肌-脂肪筋膜瓣用于骶尾部褥疮的修复,疗效满意,现报道如下。 1临床资料 本组18例,男10例,女8例,年龄50～67 岁,平均年龄60岁。病程3个月～1年,病灶部位均为骶尾部。病因:截瘫9例,骨折长期卧床3例,脑血管疾病6例。血红蛋白在60～80g/L,白蛋白在30～35g/