中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2014年
3期
227-230
,共4页
赵遵江%张保德%刘勇%章荣涛%梁其国%胡育栋%徐良媛%王修坤
趙遵江%張保德%劉勇%章榮濤%樑其國%鬍育棟%徐良媛%王脩坤
조준강%장보덕%류용%장영도%량기국%호육동%서량원%왕수곤
压力性溃疡%外科皮瓣%股骨大转子
壓力性潰瘍%外科皮瓣%股骨大轉子
압력성궤양%외과피판%고골대전자
Pressure ulcer%Surgical flaps%Greater trochanter of femur
目的 观察用股直肌岛状肌皮瓣修复瘫痪患者股骨大转子Ⅲ～Ⅳ期压疮的效果.方法 2009年7月-2013年6月,笔者单位收治13例股骨大转子Ⅲ～Ⅳ期压疮瘫痪患者,压疮面积为4.5 cm ×4.0 cm～10.0 cm ×9.0 cm,扩创后缺损面积为5.0 cm ×4.5 cm～10.5 cm ×10.0 cm.采用股直肌岛状肌皮瓣修复创面,肌皮瓣面积为5.0 cm ×5.0 cm～11.0 cm×10.0 cm,肌蒂长8～12 cm.肌蒂切取区直接拉拢缝合固定,肌皮瓣切取区行自体大腿皮移植封闭. 结果 12例肌皮瓣全部成活;1例肌皮瓣的边缘部分坏死,经换药愈合.随访2 ～30个月,13例患者均未见压疮复发.结论 股直肌岛状肌皮瓣具有设计合理、切取面积大、旋转角度大、修复后增加局部耐磨耐压度等优点,是修复瘫痪患者股骨大转子Ⅲ～Ⅳ期压疮的较佳选择.
目的 觀察用股直肌島狀肌皮瓣脩複癱瘓患者股骨大轉子Ⅲ～Ⅳ期壓瘡的效果.方法 2009年7月-2013年6月,筆者單位收治13例股骨大轉子Ⅲ～Ⅳ期壓瘡癱瘓患者,壓瘡麵積為4.5 cm ×4.0 cm～10.0 cm ×9.0 cm,擴創後缺損麵積為5.0 cm ×4.5 cm～10.5 cm ×10.0 cm.採用股直肌島狀肌皮瓣脩複創麵,肌皮瓣麵積為5.0 cm ×5.0 cm～11.0 cm×10.0 cm,肌蒂長8～12 cm.肌蒂切取區直接拉攏縫閤固定,肌皮瓣切取區行自體大腿皮移植封閉. 結果 12例肌皮瓣全部成活;1例肌皮瓣的邊緣部分壞死,經換藥愈閤.隨訪2 ～30箇月,13例患者均未見壓瘡複髮.結論 股直肌島狀肌皮瓣具有設計閤理、切取麵積大、鏇轉角度大、脩複後增加跼部耐磨耐壓度等優點,是脩複癱瘓患者股骨大轉子Ⅲ～Ⅳ期壓瘡的較佳選擇.
목적 관찰용고직기도상기피판수복탄탄환자고골대전자Ⅲ～Ⅳ기압창적효과.방법 2009년7월-2013년6월,필자단위수치13례고골대전자Ⅲ～Ⅳ기압창탄탄환자,압창면적위4.5 cm ×4.0 cm～10.0 cm ×9.0 cm,확창후결손면적위5.0 cm ×4.5 cm～10.5 cm ×10.0 cm.채용고직기도상기피판수복창면,기피판면적위5.0 cm ×5.0 cm～11.0 cm×10.0 cm,기체장8～12 cm.기체절취구직접랍롱봉합고정,기피판절취구행자체대퇴피이식봉폐. 결과 12례기피판전부성활;1례기피판적변연부분배사,경환약유합.수방2 ～30개월,13례환자균미견압창복발.결론 고직기도상기피판구유설계합리、절취면적대、선전각도대、수복후증가국부내마내압도등우점,시수복탄탄환자고골대전자Ⅲ～Ⅳ기압창적교가선택.
Objective To observe the effect of rectus femoris island myocutaneous flap for repairing bedsores in Ⅲ and Ⅳphases at the femoral greater trochanter area as a result of paraplegia.Methods Thirteen paraplegic patients who suffered bedsores in Ⅲ and Ⅳ phases at the greater trochanter of femur area were hospitalized from July 2009 to June 2013.The bedsores ranged from 4.5 cm ×4.0 cm to 10.0 cm × 9.0 cm in area.After debridement,the size of soft tissue defect ranged from 5.0 cm ×4.5 cm to 10.5 cm × 10.0 cm.Rectus femoris island myocutaneous flaps were used to repair these defects,with flap area ranging from 5.0 cm×5.0 cm to 11.0 cm ×10.0 cm and muscular pedicle length ranging from8 to 12 cm.The donor sites of muscular pedicle were closed by direct suture,while those resulted from forming myocutaneous flap were closed by the transplantation of autologous skin obtained from thigh.Results Necrosis appeared at the edge of myocutaneous flap in one patient,and it was healed after dressing change.The other 12 myocutaneous flaps survived well.Patients were followed up for 2 to 30 months,and bedsore did not recur.Conclusions Rectus femoris island myocutaneous flap,with characteristics of reasonable design,large donor area,big rotation angle,and with wear-,tear-,and pressure-resistance,is suitable for repairing bedsores at Ⅲ and Ⅳ phases at the greater trochanter of femur area in paraplegic patients.
