臀部自由穿支螺旋桨肌皮瓣修复合并深部死腔的臀部复杂性创面的临床效果

陈黎明; 王刚; 刘宏; 赵若梅; 刘晓慧; 曹广通; 姚宗江; 李志勇; 刘毅

doi:10.3760/cma.j.cn501225-20221115-00488

臀部自由穿支螺旋桨肌皮瓣修复合并深部死腔的臀部复杂性创面的临床效果

doi: 10.3760/cma.j.cn501225-20221115-00488

兰州大学第二医院烧伤整形与创面修复外科，兰州　　730030

基金项目:

甘肃省高等学校创新基金 2021B-046

甘肃省自然科学基金 21JR11RA121

详细信息

通讯作者:
刘毅，Email：liuyi196402@163.com

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出版历程
- 收稿日期: 2022-11-15

Clinical effects of free perforator propeller myocutaneous flap from buttock in repairing complex wounds in the buttock with deep dead cavity

Department of Burns and Plastic Surgery ＆ Wound Repair Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China

Funds:

Gansu Provincial University Innovation Fund 2021B-046

Gansu Natural Science Foundation of China 21JR11RA121

More Information

Corresponding author: Liu Yi, Email: liuyi196402@163.com

摘要

摘要: 目的探讨利用臀部自由穿支螺旋桨肌皮瓣修复合并深部死腔的臀部复杂性创面的可行性及临床效果。方法采用回顾性观察性研究方法。2020年6月—2022年6月，兰州大学第二医院收治9例符合入选标准的合并深部死腔的臀部复杂性创面患者，其中男6例、女3例，年龄26~62岁，原始创面面积为4.0 cm×3.0 cm~8.0 cm×7.0 cm，死腔深度为7~11 cm。均采用臀部自由穿支螺旋桨肌皮瓣修复创面，皮瓣面积为6.0 cm×2.5 cm~13.0 cm×7.0 cm，肌瓣长6~11 cm。将供区创面均直接拉拢缝合。观察术后肌皮瓣成活、并发症发生及供受区创面愈合情况。随访观察供受区外形。结果 1例患者术后2 d因引流不畅，肌皮瓣下出现淤血，经换药引流15 d愈合，其余患者肌皮瓣术后均顺利成活；供受区创面均愈合良好。随访3~10个月，供受区均外形饱满，与健侧差别不大，能够承压。结论臀部自由穿支螺旋桨肌皮瓣可以同时修复深部死腔和体表创面。采用该肌皮瓣修复合并深部死腔的臀部复杂性创面，供区损伤小，术后供受区能够承压，并能保证臀部饱满的外形。
- 臀 /
- 肌皮瓣 /
- 显微外科手术 /
- 自由穿支螺旋桨皮瓣 /
- 创面修复
Abstract: Objective To investigate the feasibility and clinical effects of using free perforator propeller myocutaneous flap from buttock in repairing complex wounds in the buttock with deep dead cavity. Methods A retrospective observational study was conducted. From June 2020 to June 2022, 9 patients with complex wounds in the buttock with deep dead cavity who met the inclusion criteria were admitted to Lanzhou University Second Hospital, including 6 males and 3 females, aged 26 to 62 years, with original wound area ranging from 4.0 cm×3.0 cm to 8.0 cm×7.0 cm and dead cavity depth of 7 to 11 cm. All the wounds were repaired with free perforator propeller myocutaneous flap from buttock, with flap area of 6.0 cm×2.5 cm to 13.0 cm×7.0 cm and muscle flap length of 6 to 11 cm. All the wounds in the donor area were closed and sutured directly. Postoperative myocutaneous flap survival, complications, as well as donor and recipient wound healing were observed, and the shape of donor and recipient areas were followed up. Results Congestion occurred under the myocutaneous flap of one patient due to poor drainage on post surgery day 2, which was healed after 15 days of drainage and dressing change. The myocutaneous flaps of other patients survived successfully after surgery. The wounds in the donor and recipient areas were all well healed. During the follow-up of 3 to 10 months, the donor and recipient areas were full in shape, with little difference from the healthy side, and were able to bear pressure. Conclusions The free perforator propeller myocutaneous flap from buttock can repair the deep dead cavity and surface wounds at the same time. The use of this myocutaneous flap in repairing complex wounds in the buttock with deep dead cavity results in minimal damage to the donor area, allows pressure-bearing of the donor and recipient areas after surgery, and ensures a full buttock shape.
- Buttocks /
- Myocutaneous flap /
- Microsurgery /
- Free perforator propeller flap /
- Wound repair
陈黎明：酝酿和设计研究、实施手术、采集资料、分析数据、撰写论文；王刚、刘宏、赵若梅：实施手术、采集资料、分析数据；刘晓慧、曹广通、姚宗江：实施手术、采集资料；李志勇：采集资料、经费支持；刘毅：酝酿和设计研究、对文章的专业知识进行审阅、修改文章及指导

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1 臀部自由穿支螺旋桨肌皮瓣修复患者骶尾部手术后切口不愈合并死腔的效果。1A.转科时骶尾部手术后切口不愈创面；1B.骨科手术后盆骨正位X线片提示双侧骶髂关节内固定术后，部分椎骨、骶骨缺如；1C.Ⅰ期清创手术后行负压封闭引流；1D.Ⅱ期术中拆除负压材料即刻；1E.Ⅱ期术中清创后；1F.肌皮瓣切取后即刻；1G.Ⅱ期术后即刻；1H.Ⅱ期术后47 d随访，臀部外形饱满，未再次破溃

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