穿支血管蒂皮瓣在臀区多部位难愈性创面修复中的应用

目的 探讨利用臀区穿支血管设计穿支蒂皮瓣,修复骶尾部、坐骨部、大转子部难愈性创面的效果. 方法 患者入院后常规采用封闭负压引流治疗6～21 d,术前以多普勒血流探测仪探测穿支血管位置,根据血管位置设计舌形、双叶、三叶旋转皮瓣或V-Y推进皮瓣修复臀区创面. 结果 自2005年以来,共利用穿支皮瓣修复14例共18处臀区创面,其中骶尾部11处,坐骨部5处,大转子部2处.术后皮瓣全部存活,随访2～24个月,皮瓣质地优良,外形满意,溃疡无复发. 结论 穿支血管蒂皮瓣可修复臀区多部位难愈性创面,供区损伤小,皮瓣血运可靠.

The gluteal perforator-based flap for repair of refractory wounds on different sites of buttocks

Objective To discuss the application of perforator-bused flap for repair of refractory sacral, ischial and trochanter wounds. Methods Vacuum sealing drainage(VSD) were applied for all the wounds for 6～21 days and cutaneous perforator was detected by Doppler before operation. According to the location of the perforator arteries, different types of perforator-based flaps were used to cover the wounds on the buttocks. Results Since 2005, 18 wounds in 14 patients were treated, including 11 sacral, 5 ischial and 2 trochanter defects. All flaps survived with primary healing. All the patients were followed up for 2 to 24 months with no ulcer relapse. The eolour and texture of the flaps were excellent with satisfactory cosmetic results. Conclusion The gluteai perforator-based flaps have reliable blood supply with less morbidity in donor sites. It is an optimal method in repairing refractory wounds of the gluteal region.