Combined gluteus maximus muscle flap and adipofascial flap for repair of stage Ⅲ and Ⅳ pressure injuries on the ischial tuberosity
Objective To investigate the therapeutic effects of combined gluteus maximus muscle flap and adipofascial flap to repair stage Ⅲ and Ⅳ pressure injuries on the ischial tuberosity.Methods A retrospective ob-servational study was conducted on 15 patients with ischial pressure injuries admitted to the 958th Hospital of Army from Jun.2018 to Sep.2020,including 10 males and 5 females aged 42-75(mean 63.7)years,with unilateral in-juries in 12 cases and bilateral injuries in 3 cases.The etiology was paraplegia caused by spinal cord injuries in 8 cases,stroke in 4 and pelvic fractures in 3.Based on the revised National Pressure Ulcer Advisory Panel(NPUAP)Pressure Injury Staging System(2016),the injuries were defined as stage Ⅲ in 5 cases and stage Ⅳ in 10.On ad-mission,the size of the defect was 2.0 cm×5.0 cm-8.5 cm×11.0 cm.At stage one,after thorough debridement,the chronic infectious lesions were turned into sterile fresh incisions;then fill the cavity with the gluteus maximus muscle flap and cover the wound with the designed adipofascial flap.The wound healing,recurrence of pressure ul-cers,appearance of the affected area,and secondary dysfunctions and deformity of the donor site were observed dur-ing the follow-up.Results Thirteen patients obtained primary grade Ⅰ healing of the wound,and the other two patients had fecal pollution,which achieved healing after secondary debridement and dressing change.All patients were followed up for 16-24 months,mean 20.3 months.Until final follow-up,no recurred ulcer was observed,and the skin of the affected area showed good texture,full shape and mild pigmentation without sinus tract,secondary dysfunction or deformity of the donor site.Conclusion Gluteus maximus muscle flap combined with adipofascial flap is a good choice to repair stage Ⅲ and Ⅳ pressure injuries on the ischial tuberosity,with good therapeutic out-comes and seldom recurrence.
Pressure injuriesGluteus maximus muscle flapAdipofascial flapIschial tuberosity
万方数据
维普
