负压封闭引流联合臀大肌肌皮瓣转移修复骶尾部难治性褥疮

目的探讨应用负压封闭引流(VSD)结合臀大肌肌皮瓣治疗难治性骶尾部褥疮的临床疗效。方法 2010年7月至2012年7月共应用VSD结合臀大肌肌皮瓣修复难治性骶尾部褥疮14例。一期行清创手术后放置负压封闭引流装置7~14 d,联合药物及营养支持等治疗。二期采用臀大肌肌皮瓣转移修复缺损。结果本组全部患者经封闭负压引流7~14 d后,创面均逐渐缩小,缺损组织处可见新鲜肉芽组织生长,创面脓性分泌物及坏死组织明显减少,感染得到控制。二期行臀大肌肌皮瓣瓣转移修复创面,皮瓣最终均成活,创面修复满意,患者生活质量得到提高。结论 VSD联合应用臀大肌肌皮瓣是修复骶尾部严重褥疮理想的治疗方式,可缩短病程,具有较好的临床实用价值。

Vacuum sealing drainage with gluteus maximus myocutaneous flap reconstruction in the repair of bedsore

Objective To derive a more precise estimation of VSD combined with gluteus maximus myocutaneous flap reconstruction in the treatment of bedsore. Methods A retrospective study was performed in 14 patients with bedsore who were treated using the combination of VSD and gluteus maximus myocutaneous flap in our hospital from July 2010 to July 2012. After debridement, wound of patients was dealt with VSD for 7 - 14 days, combined with medication and nutritional support, then repaired with gluteus maximus myocutaneous flap in the reconstruction of bedsore. Results When all patients were dealt with VSD for 7 - 14 days, it was detected that the surface of wound reduced, granulation tissue formed, purulent secretion and necrotic tissue reduced obviously, which provided a good condition for the surgery treatment. The bedsore recovered satisfactorily when applied treatment of gluteus maximus myocutaneous flap reconstruction. Conclusion VSD combined with gluteus maximus myocutaneous flap reconstruction is an ideal method for the repair of bedsore.