臀部感染创面局部皮瓣手术治疗策略

目的:臀部为褥疮等难治性创面的好发区域,且常合并感染,为临床治疗的难点.本文旨在探讨应用臀部局部肌皮瓣及穿支皮瓣治疗该位置难治性创面的指征及适应证.方法:针对不同位置、不同深度的臀部创面,根据各类皮瓣及肌皮瓣的血管蒂位置与长度,制定临床治疗流程图,以选择合适的治疗方案.结果:北京协和医院整形外科臀部创面患者15名,应用不同的局部带蒂皮瓣进行手术治疗.随访6～12个月(平均8.7个月),其中1例患者出现皮瓣远端坏死(6.67%),其余患者皮瓣全部成活.结论:臀部为良好的皮瓣供区,可以根据创面特点选择不同位置、不同类型的局部皮瓣,解决大部分难治性创面覆盖的问题.

Reconstruction of sacral area soft tissue defect: an algorithm for treatment

Objective Soft tissue defect of the sacral area usually combined with different kinds of infection,which remains to be difficult to treat with the traditional methods.We aimed to discuss the indications of local flap coverage for the chronic wound in this area.Methods An algorithm of treatment to such kind of wound has been made according to the depth,location and clinical condition of different sacral defect and concerning about the pedicle length and location of different local flaps.Results 15 patients suffered sacral area soft tissue defect received different operations according to the algorithm.Follow-up time is 6～12 months(average 8.7 months).One flap suffered tip necrosis(6.675),all the other flaps 100% survived.Conclusion There are many kinds of local flaps available in sacral area.According to our algorithm,most of the chronic wounds in this area could be successfully covered by different kinds of local flaps.