臀上动脉穿支皮瓣在修复骶尾部压疮的应用

目的观察臀上动脉穿支皮瓣修复骶尾部压疮的效果。方法收集采用臀上动脉穿支皮瓣修复大面积骶尾部压疮创面20例，压疮形成时间3个月至10年，创面大小为8 cm×7 cm~16 cm×12 cm，皮瓣切取范围14 cm×6.5 cm~20 cm×18 cm。结果3例皮瓣出现远端小面积坏死，经换药等对症处理后Ⅱ期愈合，1例皮瓣在术后2 d出现静脉淤血及肿胀，采用部分清创及对侧臀上动脉穿支皮瓣修复创面，余16例皮瓣均Ⅰ期愈合，供区游离皮片生长良好，术后随访1年，皮瓣区外形良好，臀大肌外形及功能完好，无局部复发。结论臀上动脉穿支皮瓣血供丰富，成活率高，设计灵活，是目前修复骶尾部压疮创面的理想方法。

Application of superior gluteal artery perforator flap in repairing sacrococcygeal pressure sores

ObjectiveTo investigate the effects of superior gluteal artery perforator flap in repairing sacrococcygeal pressure sores.MethodsTwenty patients with sacrococcygeal pressure sores were repaired with superior gluteal artery perforator flap.The formation time of pressure sores ranged from 3 months to 10 years, the size of pressure sores ranged from 8 cm×7 cm to 16 cm×12 cm, and the size of flaps ranged from 14 cm×6.5 cm to 20 cm×18 cm.ResultsThree cases with partial necrosis of flap were the secondary healing after symptomatic treatment, 1 case with vein congestion and swelling at postoperative 2 days was treated with partial debridement and superior gluteal artery perforator flap repair, and the primary healing and good growth of free skin in the donor area in 16 cases were identified.All cases were followed up for 1 year, the shape of the flap area was good, the shape and function of gluteus maximus were intact, and there was not local recurrence.ConclusionsSuperior gluteal artery perforator flap can provide rich blood supply, has high survival rate and flexible design, which is an ideal method to repair sacrococcygeal pressure ulcer wound.