岛状臀大肌肌皮瓣修复骶部褥疮

为提高修复成功率，采用带蒂部分臀大肌岛状皮瓣转位一次完成修复骶部褥疮１４例。经临床观察及随访，皮瓣愈合良好，无一例复发。结论认为，本肌皮瓣具有成活率高，手术操作简单，供区无需植皮，可一次完成骶部较大褥疮的修复，是较理想的手术方法。     

岛状臀大肌肌皮瓣修复骶疗褥疮

为提高修复成功率，采用带蒂部分臀大肌岛状皮瓣转位一次完成修复骶部褥疮１４例，经临床观察及随访，皮瓣愈合良好，无一例良复，结论认为，本肌皮瓣具有成活率高，手术操作简单，供区无需植皮，可一次完成骶部较大褥疮的修复，是较理想的手术方法。     

臀大肌肌皮瓣移位治疗臀骶部褥疮

应用4种臀大肌肌皮瓣,即上部臀大肌肌皮瓣、下部臀大肌肌皮瓣、双侧V—Y推进肌皮瓣和全臀股部旋转肌皮瓣修复13例(14处)骶部、坐骨结节部、大粗隆部褥疮,效果满意。     

臀上动脉浅支臀大肌岛状肌皮瓣修复骶尾部褥疮

目的研究应用臀大肌肌皮瓣修复骶部褥疮的临床疗效。方法自2000年10月至2008年1月应用带臀上动脉浅支的臀大肌上部肌皮瓣转移修复骶尾部褥疮5例。男4例,女1例;年龄35-65岁,平均45岁。颈椎脱位并截瘫1例,胸腰段骨折脱位并截瘫3例,脑血栓1例。结果 5例患者均一期修复成功,切取皮瓣面积最小8 cm×6cm,最大13 cm×10 cm。随访6个月-2年,平均13个月。肌皮瓣生长良好,无复发。结论应用带臀上动脉浅支的臀大肌上部肌皮瓣修复骶尾部褥疮具有操作简单、皮瓣血运好、供区无需植皮、并发症少、成功率高、可一期完成修复等优点,值得推广应用。     

改良臀大肌肌皮瓣修复骶尾部褥疮

我们自１９８９年６月以来,采用改良的臀大肌肌皮瓣移植术修复骶尾部褥疮３３例,取得了较为满意的治疗效果。临床资料３３例中男２４例,女９例;年龄２０～６５岁。胸腰椎骨折并截瘫２０例（全瘫１４例,不全瘫６例）,骨盆骨折５例,颅脑损伤３例,脑血管出血２例,双...     

臀大肌肌皮瓣修复骶尾部褥疮的疗效观察

目的探讨应用臀大肌肌皮瓣修复骶尾部褥疮的临床疗效。方法应用带臀上动脉浅支或臀下动脉皮支的臀大肌皮瓣转移修复骶尾部褥疮12例。结果12例患者均一期修复,切取肌皮瓣面积14 cm×10 cm～10 cm×6cm,随访1～2年,肌皮瓣生长良好,无复发。结论应用臀大肌皮瓣修复骶尾部褥疮具有操作简便、皮瓣血运好、供区无需植皮、并发症少、成功率高、可一期完成修复等优点,是治疗骶尾部褥疮较理想的方法。     

The inferiorly based rectus abdominis myocutaneous flap for recurrent pelvic pressure sores in neurologically impaired patients

Summary The inferiorly based rectus abdominis myocutaneous flap, developed by Taylor, is a reliable flap which when raised spares the anterior sheath of the muscle below the arcuate line. The muscle can fill an infected, hypovascular wound and the extensive skin paddle can cover a large cutaneous loss of substance, so the flap is perfectly suited to coverage of recurrent pressure sores in paraplegic patients. We used 11 flaps in 10 paraplegic patients for recurrent pelvic pressure sores which were ischial in six cases, trochanteric in four and sacral in one. We describe the operative technique and stress the importance of using an extraperitoneal, intrapelvic and transiliac approach. Healing was obtained in all cases without functional deficit of the abdominal wall (no abdominal herniation, one contour deformity). This flap offers two further options for treatment of recurrent pelvic pressure sores whatever their location and its indications are more and more frequent in an aging population of paraplegic patients.     

Total thigh and leg myocutaneous flap for repair of multiple pressure ulcers

Summary A large myocutaneous flap obtained by filleting the lower limb was used to cover the defect resulting from excision of three extensive pressure sores in a single operative procedure. The procedure was easy and time saving. It has left the patient with soft tissue reserves in the event there should be recurrence of decubitis in the future.     

The gluteus maximus musculocutaneous flap as bilateral V-Y sliding flap or as pendulum flap for closure of sacral and ischial pressure sores

Summary Eight V-Y and fourteen pendulum gluteus maximus myocutaneous flaps have been used in eighteen patients for closure of sacral and ischial pressure sores. The patients have been followed-up for between 3 and 36 months and there was only one recurrence in a patient who had had a bilateral pendulum flap. There has been no functional impairment in the ambulant patients.     

臀上皮神经营养血管皮瓣转位修复骶尾部褥疮

目的 观察臀上皮神经营养血管皮瓣修复骶尾部褥疮的效果.方法从2005年5月至2009年12月,临床上对12例骶尾部褥疮采用臀上肌营养血管皮瓣转位修复,褥疮面积最大15 cm×30 cm,最小5 cm×8 cm,皮瓣最大面积17 cm×32 cm,最小10×12 cm.结果 12例皮瓣全部成活,褥疮治愈.术后最长随访时间为4年,最短为半年,平均为2.5年.随访发现皮瓣血运良好,褥疮无复发.结论 臀上皮神经营养血管皮瓣血供可靠,切取简单,是修复骶尾部褥疮较好的方法.

Abstract：

Objective To observe the clinical outcomes of the superior gluteal neurocutaneous flap for sacrococcygeal pressure sores. Methods Twelve cases with sacrococcygeal pressure sores were covered by the superior gluteal neurocutaneous flap from May 2005 to Nov. 2009. The sore size ranged from 15 cm ×30 cm to 5 cm × 8 cm, while the flap size ranged from 17 cm × 32 cm to 10 cm× 12 cm. Results All 12 flaps survived totally with the pressure sores healed. The longest follow-up time was four years, the short follow-up time was half a year, the average time was 2.5 years. The superior gluteal neurocutaneous flap was good blood circulation, pressure sores not recur. Conclusion The superior gluteal neurocutaneous flap is a good treatment for sacrococcygeal pressure sores for its reliable blood supply and simple harvesting.     

负压封闭引流结合臀大肌肌皮瓣在骶尾部褥疮修复中的应用

[目的]探讨负压封闭引流(VSD)结合臀大肌肌皮瓣修复骶尾部褥疮的临床效果.[方法]选择2005年2月～2009年2月收治的骶尾部褥疮患者31例,男17例,女14例;年龄30～ 75岁,病程0.2 ～20年.创面面积:5cm×6.5cm～8cm×12.5cm.随机分为两组:治疗组16例,创面先经负压封闭引流处理,设计以臀上动脉浅支为血管蒂的臀大肌上部肌皮瓣,修复骶尾部褥疮.对照组15例,常规换药处理后臀大肌上部肌皮瓣修复.[结果] 29例患者皮瓣一期存活,试验组和对照组各有1例皮瓣远端部分坏死,经换药后愈合.治疗过程中无大出血、血管神经损伤、感染等并发症.所有患者均获随访,随访时间12 ～18个月,肌皮瓣质地良好,褥疮无复发,功能满意.试验组在换药次数、住院时间及抗生素使用等方面优于对照组,差异有统计学意义(P＜0.01).[结论]应用负压封闭引流结合臀大肌肌皮瓣修复骶尾部褥疮,能够明显缩短病程,并发症少,成功率高,是治疗骶尾部褥疮的理想方法之一.     

The long-term management of sacral,ischial and trochanteric pressure sores by Myocutaneous Island flaps and their postoperative course

Summary Thirty-three patients, mostly paraplegics, were treated for chronic pressure sores Campbell stages IV–VI overlying the sacrum, the ischial tuberosity and the femoral tuberosity. A stable, multi-layered cover of the defect, following excision of the decubiti, could be achieved in one stage using single myocutaneous gluteus maximus and biceps femoris island flaps or, when indicated, a combination of both. The postoperative complication rate was 7/65 (65 myocutaneous flaps were used in 33 patients) or 10.8%. Except for one recurrence due to a traumatic hematoma causing subtotal, external compression of the axial vascular pedicle and consequent partial necrosis of the myocutaneous island flap, all other flaps provided adequate closure and padding. They provided durable cover over a mean follow-up period of 25 months. These results are compared with the relevant literature.