CAJ | 학술논문

目的：探讨臀上动脉穿支皮瓣修复骶尾部难治性褥疮的临床疗效。方法收集2004年3月—2012年4月骶尾部较大面积褥疮患者19例。其中Ⅲ度褥疮10例，Ⅳ度褥疮9例；男15例，女4例；年龄35～69岁；骶尾部褥疮面积11 cm ×13 cm～22 cm ×24 cm，平均17 cm ×19 cm。术前常规采用多普勒超声探测穿支点并用龙胆紫标记，术前常规行臀部磁共振检查并筛除双臀肌纤维化的患者，应用臀上动脉穿支皮瓣对骶尾部褥疮创面进行覆盖，观察疗效。结果19例臀上动脉穿支皮瓣全部成活，术后随访3～39个月，平均23个月，皮瓣无臃肿，外形良好，褥疮无复发，臀大肌功能正常。结论臀上动脉穿支皮瓣血供丰富，可应用皮瓣范围大，切取方便，操作简单，保留臀大肌，无需植皮，是修复骶尾部难治性褥疮的理想方法。
목적：탐토둔상동맥천지피판수복저미부난치성욕창적림상료효。방법수집2004년3월—2012년4월저미부교대면적욕창환자19례。기중Ⅲ도욕창10례，Ⅳ도욕창9례；남15례，녀4례；년령35～69세；저미부욕창면적11 cm ×13 cm～22 cm ×24 cm，평균17 cm ×19 cm。술전상규채용다보륵초성탐측천지점병용룡담자표기，술전상규행둔부자공진검사병사제쌍둔기섬유화적환자，응용둔상동맥천지피판대저미부욕창창면진행복개，관찰료효。결과19례둔상동맥천지피판전부성활，술후수방3～39개월，평균23개월，피판무옹종，외형량호，욕창무복발，둔대기공능정상。결론둔상동맥천지피판혈공봉부，가응용피판범위대，절취방편，조작간단，보류둔대기，무수식피，시수복저미부난치성욕창적이상방법。
Objective To investigate clinical efficacy of superior gluteal artery perforator flap in repairing sacral decubitus. Methods From March 2004 to April 2012, 19 patients with sacral decubitus were enrolled in the study aged from 35-69 years old, including 10 cases in stageⅢand 9 cases in stageⅣ.15 were male and 4 were female.Sacrococcygeal decubi-tus areas ranged from 11 cm ×13 cm to 22 cm ×24 cm, with an average of 17 cm ×19 cm.Doppler ultrasound probe was used to detect wear fulcrum with gentian violet mark, and hip MRI was used to screen out patients with double gluteal mus-cle fibers.Sacrococcygeal decubitus wound was covered by the superior gluteal artery perforator flap.Results All of the 19 patients with superior gluteal artery perforator flaps survived and were followed up for 23 months ( range from 3 to 39 months) .The appearance of gluteal region were satisfactory without bloated shape or recurrence bedsores.Conclusion Su-perior gluteal artery perforator flap can be used efficiently in reconstruction of sacral decubitus.It provides rich blood sup-ply, is easy to harvest and operate, and reserves the maximal function of the gluteus without skin graft.