股深动脉第1穿动脉穿支皮瓣修复臀股部IV期压疮疗效

目的　探讨应用股深动脉第1穿动脉穿支皮瓣修复臀股部IV期压疮的可行性。 方法　2016年1月至2019年2月，本院手足创伤骨科收治9例臀股部IV期压疮患者，男3例，女6例，年龄26~68岁，平均46岁。截瘫原因：高处坠落伤4例，车祸伤3例，脑梗塞2例。清创后创面面积8 cm×5 cm~18 cm×9 cm。根据创面形状、大小及位置设计股深动脉第1穿动脉穿支皮瓣修复压疮创面，皮瓣面积为10 cm×7 cm~20 cm×10 cm。 结果　所有皮瓣成活，其中2例术后局部渗液较多，经积极保守换药治疗后，皮瓣恢复良好。9例获得6~24月随访，平均13月，皮瓣色泽良好，质地柔软，不影响日常生活，压疮未见复发。 结论　股深动脉第1穿动脉穿支皮瓣操作简便，血供可靠，可供组织量较多，是修复臀股部IV期压疮的较好选择。

Clinical application of the perforator flap based on the first perforating branch of profunda femoral artery in reconstruction of patients with IV degree pressure ulcers in the region of buttock and thigh

Objective　To investigate the feasibility of the perforator flap based on the first perforating branch of profunda femoral artery in reconstruction of patients with IV degree pressure ulcers in the region of buttock and thigh.　Methods　From January 2016 to February 2019, nine patients with IV degree pressure ulcers in the region of buttock and thigh were admitted to the department of Trauma and Orthopaedics, the Second people's Hospital of Xining city, including 3 males and 6 females, aged from 26~68 years, with an average age of 46 years. The causes of paraplegia were fall injury in 4 cases, traffic accident injury in 3 cases and cerebral infarction in 2 cases. After debridement, the wound area was 8 cm×5 cm~18 cm×9 cm. According to the shape, size and location of the wound, the perforator flap was designed to repair the pressure ulcers wound based on the first perforating branch of profunda femoral artery. The flap area was 10 cm×7 cm~20 cm×10 cm.　 Results　All flaps survived completely, including 2 cases with more local inflammatory exudates, and the flap recovered well after active conservative treating. 9 cases were followed up for 6 to 24 months, with an average of 13 months. The skin flap was good in color, soft in texture, and it did not affect daily life. No recurrence of pressure ulcers was found.　Conclusions　The perforator flap based on the first perforating branch of profunda femoral artery is easy to operate, reliable in blood supply and large amount of tissue supply. It is a better choice for the repair of patients with IV degree pressure sore in the region of buttock and thigh.