CAJ | 학술논문

目的探讨骶尾部软组织缺损的修复方法及临床效果. 方法 2008年1月-2013年4月,共收治骶尾部全层软组织缺损的患者18例,其中男8例,女10例,年龄34 ～ 78岁.创面缺损范围3.0 cm×2.0 cm ～ 18.0 cm×14.0 cm,均应用双侧臀大肌旋转推进皮瓣予以修复,术中两侧常规留置引流管各1枚.术后应用持续负压吸引10 ～ 12 d. 结果皮瓣切取面积为12.0 cm×8.0 cm ～ 18.0 cm× 12.0 cm,皮瓣供区一期间断缝合.术后皮瓣成活率94.44％(17/18),皮瓣坏死部分通过换药愈合.随访14例,随访时间为8个月～2.5年,平均18个月,移植皮瓣的颜色、质地满意,厚薄适中,无骶尾部皮肤再次破溃或软组织缺损发生,患者满意. 结论对于骶尾部软组织大面积缺损患者,应用双侧臀大肌旋转推进皮瓣联合术后持续负压吸引予以修复可有效闭合创面,效果满意,值得临床借鉴与推广.
목적 탐토저미부연조직결손적수복방법급림상효과. 방법 2008년1월-2013년4월,공수치저미부전층연조직결손적환자18례,기중남8례,녀10례,년령34 ～ 78세.창면결손범위3.0 cm×2.0 cm ～ 18.0 cm×14.0 cm,균응용쌍측둔대기선전추진피판여이수복,술중량측상규류치인류관각1매.술후응용지속부압흡인10 ～ 12 d. 결과 피판절취면적위12.0 cm×8.0 cm ～ 18.0 cm× 12.0 cm,피판공구일기간단봉합.술후피판성활솔94.44％(17/18),피판배사부분통과환약유합.수방14례,수방시간위8개월～2.5년,평균18개월,이식피판적안색、질지만의,후박괄중,무저미부피부재차파궤혹연조직결손발생,환자만의. 결론 대우저미부연조직대면적결손환자,응용쌍측둔대기선전추진피판연합술후지속부압흡인여이수복가유효폐합창면,효과만의,치득림상차감여추엄.
Objective To demonstrate the clinical outcome of bilateral gluteus maximus musculocutaneous flap in conjunction with continuous postoperative negative pressure wound therapy in reconstruction of sacral soft tissue defects.Methods From January, 2008 to April, 2013, 18 patients (8 males and 10 females, aged from 34 to 78 years old) with full-thickness sacral soft tissue defects were treated.The size of the defects after initial debridement ranged from 3.0 cm × 2.0 cm to 18.0 cm × 14.0 cm, with the exposure of sacrum or ligament.Bilateral gluteus maximus musculocutaneous flap were applied in all the patients.Two drainage tubes were placed on each side of the flaps during the surgery and suck for 10 to 12 consecutive days after the operation.Results The size of the harvested flaps ranged from 12.0 cm × 8.0 cm to 18.0 cm × 12.0 cm, and all the donor sites of the flaps were closed with primary suture.Thirty-five flaps in 17 patients survived without any complication.Partial necrosis of one flap was found in 1 patient and managed successfully with conservative dressing change.Fourteen patients were followed-up ranged from 8 months to 2.5 years (mean follow-up was 18 months).Color and texture of the flaps were satisfactory and no recurrence of sacral defect was noted.Conclusion Bilateral gluteus maximus musculocutaneous flap in conjunction with continuous postoperative negative pressure wound therapy may serve as a useful option for fullthickness sacral soft tissue defects.