Clinical effect of unilateral superior gluteal artery perforator propeller flap combined with contralateral centripetal advancement flap in repairing huge pressure ulcers in the sacrococcygeal region
Objective To explore the feasibility and clinical effects of unilateral superior gluteal artery perforator propeller flap combined with contralateral centripetal advancement flap in repairing huge pressure ulcers in the sacrococcygeal region.Methods The study was a retrospective observational study.From June 2020 to April 2023,15 patients with stage Ⅳ pressure ulcers with sacrococcygeal defect area greater than 10.0 cm×10.0 cm who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University,including 8 males and 7 females,aged from 30 to 86 years.The pressure ulcers before debridement were all accompanied by different degree of infection and necrosis.Debridement and negative pressure sealing and irrigation treatment were performed in stage Ⅰ.After debridement,the skin and soft tissue defect area was 12.0 cm×10.5 cm to 20.0 cm×17.0 cm.After the wound bed infection was controlled,unilateral superior gluteal artery perforator propeller flap combined with contralateral centripetal advancement flap was used to repair the pressure ulcer wounds in stage Ⅱ.The perforator flap area was 12.0 cm×7.0 cm to 16.0 cm×10.5 cm.The donor area wound was sutured directly.After operation,the survival,complications,and wound healing of flap donor area were observed.During regular follow-up,the recurrence of pressure ulcers,the appearance and texture of the flap,and the scars in the donor site were observed.Results After operation,1 patient had fluid accumulation under the flap and survived after drainage and dressing change.The flaps of the other patients survived well without infection,local necrosis,and sinus formation under the flap.The wounds in the donor area healed well.All patients were followed up for more than 6 months,and there was no recurrence of pressure ulcers.The appearance of the flap was not bloated,the texture was soft,and the compression resistance and elasticity were good.The donor site wound healed well without obvious scar.Conclusions The surgical method of repairing giant sacrococcygeal pressure ulcers with unilateral superior gluteal artery perforator propeller flap combined with contralateral centripetal advancement flap is simple and easy to operate.It can repair large defect area with the donor area being sutured directly,which is worthy of clinical promotion.
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