摘要
目的 报告蝴蝶形皮瓣修复骶部大面积褥疮的临床结果.方法 自2006年3月至2010年10月间,应用这种技术修复6例(男5例,女1例)骶部大面积褥疮.年龄22~58岁,平均38岁.其中完全性脊髓损伤3例,烫伤2例,脑梗塞1例.均为骶部Ⅳ度褥疮,深度达骨面.创面大小:12 cm×14 cm~13 cm×18 cm.每侧皮瓣均以第4腰动脉穿支为蒂,皮瓣轴斜向髂前上棘,皮瓣的外形类似一只蝴蝶.供区缺损一期缝合.结果 1例术后发生表浅感染,经更换敷料逐渐愈合.所有患者经26~52个月随访(平均38个月),皮瓣全部成活.所有缺损均修复成功,没有发生伤口血肿与裂开.骶部褥疮没有复发,取得了较满意的效果.结论 蝴蝶形皮瓣技术是修复骶部褥疮较好的治疗方法,当病例选择适当时,并发症少,成功率高.
Abstract
Objective To report the clinical results of the coverage of a large sacral pressure sores with the butterfly flap.Methods Between March 2006 and October 2010,6 cases a large sacral pressure sores(5 men,1 women)were re-constructed with the technique.They ranged in age from 22 to 58 years(mean 38).Of the 6 cases,3 cases were complete spinal cord injury.Two were burn injury.One was cerebral infarction.All of the patients had stage Ⅳ decubitus ulcers that extended to the bone.The pressure sores ranged in size from 12 cm×14 cm to 13 cm×18 cm.Each flap was pedi-cled on the fourth lumbar artery perforators,The flaps designed with the axis obique to the anterior superior iliac spine. The configuration of the flaps resembles a butterfly.Donor sites defect were closed primarily.Results One case sus-tained superficial infection postoperative and the gradual wound healed by daily wound dressings.All patients were fol-lowed-up from 26 to 52 months(mean,38 months).All flaps survived;hematoma,or wound dehiscence was not ob-served.No recurrence of the sacral pressure sores occurred with satisfactory clinical results.Conclusion The butterfly flap technique is a reliable surgical method for sacral pressure sores reconstruction.When used in appropriate cases, there is minimal morbidity and the outcome is highly successful.
NETL
NSTL
维普
万方数据