皮瓣和肌皮瓣移植加创面灌洗修复截瘫后多发性压疮

背景：压疮是截瘫患者的常见并发症,严重的压疮通过保守治疗难以治愈。目的：观察皮瓣和肌皮瓣加创面灌洗治疗截瘫患者多发性压疮的修复效果。方法：纳入2007-01/2010-12在北京积水潭医院烧伤整形科治疗的16例多部位严重压疮的截瘫患者,均伴有不同程度的骨质破坏。手术中彻底扩创,去除死骨、瘢痕及感染肉芽组织,以皮瓣或肌皮瓣覆盖创面,术后灌洗治疗。结果与结论：纳入的16例患者创面全部Ⅰ期愈合,出院3个月后随访,修复部位压疮均未出现复发。说明皮瓣和肌皮瓣修复加创面灌洗治疗对截瘫患者压疮有良好的修复效果。

Flap and musculocutaneous flap grafting plus irrigation for the repair of multiple decubitus ulcers after paraplegia

BACKGROUND：Decubitus ulcer is a common complication in paraplegia patients.Severe decubitus ulcer is difficult to cure by conservative therapies.OBJECTIVE：To explore the therapeutic efficacy of flap and musculocutaneous flap grafting plus irrigation in the repair of multiple decubitus ulcers after paraplegia METHODS：A total of 16 paraplegia patients with multiple decubitus ulcers who received medical service in the Department of Burn and Plastic Surgery of Beijing Jishuitan Hospital from January 2007 to December 2010 were included.All cases were combined with different degrees of bone destruction.Surgery involved wound debridement and bone scraps,sequestrum,scars and infected granulation tissues were removed.Then the wound surfaces were covered by flap or musculocutaneous flap.The wounds were irrigated after operation.RESULTS AND CONCLUSION：Wounds in all 16 cases healed by first intention.No recurrence was found in the 3rd month follow-up after patients leaving the hospital.Flap and musculocutaneous flap grafting plus irrigation is effective to cure the multiple decubitus ulcers after paraplegia.