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Volume 38 Issue 4
Apr.  2022
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2022  >  38(4): 363-368
Liu BQ,Dong DS,Shi MY,et al.Clinical effects of en bloc resection and debridement combined with gluteus maximus muscle flap in the treatment of ischial tubercle pressure ulcer complicated with chronic osteomyelitis[J].Chin J Burns Wounds,2022,38(4):363-368.DOI: 10.3760/cma.j.cn501120-20210122-00032.
Citation: Liu BQ,Dong DS,Shi MY,et al.Clinical effects of en bloc resection and debridement combined with gluteus maximus muscle flap in the treatment of ischial tubercle pressure ulcer complicated with chronic osteomyelitis[J].Chin J Burns Wounds,2022,38(4):363-368.DOI: 10.3760/cma.j.cn501120-20210122-00032.
shu

Clinical effects of en bloc resection and debridement combined with gluteus maximus muscle flap in the treatment of ischial tubercle pressure ulcer complicated with chronic osteomyelitis

doi: 10.3760/cma.j.cn501120-20210122-00032

  • Department of Hand and Foot Surgery, Fuyang Minsheng Hospital, Fuyang 236072, China

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  • Corresponding author: Liu Benquan, Email: liubenquan2010@163.com
  • Received Date: 2021-01-22
    Abstract
  •   Objective  To investigate the clinical effects of en bloc resection and debridement combined with gluteus maximus muscle flap in the treatment of ischial tubercle pressure ulcer complicated with chronic osteomyelitis.  Methods  A retrospective observational study was conducted. From May 2018 to February 2020, 8 patients with pressure ulcers on the ischial tuberosity combined with chronic osteomyelitis who met the inclusion criteria were admitted to Fuyang Minsheng Hospital, including 5 males and 3 females, aged 38-69 years, with unilateral lesions in 6 patients and bilateral lesions in 2 patients. According to the anatomical classification of Cierny-Mader osteomyelitis, there were 6 patients (7 sides) with focal type, and 2 patients (3 sides) with diffuse type. The wound areas were 3 cm×2 cm to 12 cm×9 cm on admission. The pressure ulcer and chronic osteomyelitis lesions were completely removed by en bloc resection and debridement. The chronic infectious lesions were transformed into sterile incisions like fresh wounds by one surgical procedure, and the gluteus maximus muscle flaps with areas of 10 cm×6 cm to 15 cm×9 cm were excised to transfer and fill the ineffective cavity. The wounds of 5 patients were sutured directly, and the wounds of 3 patients were closed by local flap transfer. The intraoperative blood loss volume and blood transfusion, and length of hospital stay of patients were recorded. The incision healing and flap survival of patients were observed after operation. The recurrence of pressure ulcer and osteomyelitis, the appearance of the affected area, and the secondary dysfunction and deformity of the muscle flap donor site of patients were observed during followed up.  Results  The intraoperative blood loss volume of the 8 patients was 220 to 900 (430±150) mL; 5 patients received intraoperative blood transfusion, of which 2 patients received 3 U suspended red blood cells and 3 patients received 2 U suspended red blood cells. The length of hospital stay was 18 to 29 (23.5±2.0) d for the 8 patients. In this group of patients, the incisions of 7 patients healed, while in one case, the incision suture was torn off during turning over and healed after secondary suture. The flaps survived well in 3 patients who underwent local flap transfer. During the follow-up period of 6-20 months, no recurrence of pressure ulcer or osteomyelitis occurred in 8 patients, the affected part had skin with good texture, mild pigmentation, and no sinus tract formation, and no secondary dysfunction or deformity occurred in the donor site.  Conclusions  The en bloc resection and debridement combined with gluteus maximus muscle flap has good clinical effects on ischial tubercle pressure ulcer complicated with chronic osteomyelitis. Neither pressure ulcer nor osteomyelitis recurs post operation. The skin texture and appearance of the affected area are good, and the donor site has no secondary dysfunction or deformity.

     

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    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 4.4 %其他: 4.4 %其他: 0.7 %其他: 0.7 %China: 1.7 %China: 1.7 %Kao-sung: 0.2 %Kao-sung: 0.2 %San Lorenzo: 0.9 %San Lorenzo: 0.9 %Seattle: 0.2 %Seattle: 0.2 %United States: 0.2 %United States: 0.2 %[]: 0.2 %[]: 0.2 %上海: 1.7 %上海: 1.7 %伊春: 0.7 %伊春: 0.7 %六安: 0.9 %六安: 0.9 %兰州: 0.7 %兰州: 0.7 %北京: 1.7 %北京: 1.7 %北方邦: 0.2 %北方邦: 0.2 %南京: 0.9 %南京: 0.9 %南宁: 0.4 %南宁: 0.4 %南昌: 0.7 %南昌: 0.7 %南通: 0.2 %南通: 0.2 %厦门: 0.2 %厦门: 0.2 %合肥: 0.7 %合肥: 0.7 %周口: 2.8 %周口: 2.8 %呼和浩特: 0.7 %呼和浩特: 0.7 %哥伦布: 0.2 %哥伦布: 0.2 %唐山: 0.4 %唐山: 0.4 %商丘: 0.2 %商丘: 0.2 %大连: 0.2 %大连: 0.2 %天津: 0.7 %天津: 0.7 %太原: 0.4 %太原: 0.4 %威海: 0.2 %威海: 0.2 %安康: 0.2 %安康: 0.2 %山景城: 0.2 %山景城: 0.2 %常州: 0.2 %常州: 0.2 %平顶山: 0.4 %平顶山: 0.4 %广州: 0.4 %广州: 0.4 %张家口: 2.6 %张家口: 2.6 %张家界: 0.2 %张家界: 0.2 %徐州: 0.4 %徐州: 0.4 %成都: 0.7 %成都: 0.7 %扬州: 0.2 %扬州: 0.2 %拉贾斯坦邦: 0.9 %拉贾斯坦邦: 0.9 %新布朗斯维克: 1.1 %新布朗斯维克: 1.1 %无锡: 0.2 %无锡: 0.2 %昆明: 2.6 %昆明: 2.6 %普赖恩维尔: 0.7 %普赖恩维尔: 0.7 %杭州: 3.1 %杭州: 3.1 %桂林: 0.2 %桂林: 0.2 %武汉: 1.5 %武汉: 1.5 %汕头: 0.2 %汕头: 0.2 %济南: 2.4 %济南: 2.4 %海口: 0.4 %海口: 0.4 %海得拉巴: 0.7 %海得拉巴: 0.7 %深圳: 0.2 %深圳: 0.2 %漯河: 0.9 %漯河: 0.9 %潍坊: 0.2 %潍坊: 0.2 %石家庄: 0.7 %石家庄: 0.7 %秦皇岛: 0.2 %秦皇岛: 0.2 %芒廷维尤: 32.3 %芒廷维尤: 32.3 %芝加哥: 0.7 %芝加哥: 0.7 %苏州: 0.4 %苏州: 0.4 %荆门: 0.9 %荆门: 0.9 %衡水: 0.7 %衡水: 0.7 %衡阳: 0.2 %衡阳: 0.2 %衢州: 0.7 %衢州: 0.7 %西宁: 1.7 %西宁: 1.7 %西安: 0.7 %西安: 0.7 %贵阳: 0.2 %贵阳: 0.2 %运城: 0.4 %运城: 0.4 %遵义: 0.4 %遵义: 0.4 %郑州: 1.3 %郑州: 1.3 %重庆: 11.4 %重庆: 11.4 %长春: 0.2 %长春: 0.2 %长沙: 0.9 %长沙: 0.9 %韶关: 1.5 %韶关: 1.5 %黄冈: 0.2 %黄冈: 0.2 %其他其他ChinaKao-sungSan LorenzoSeattleUnited States[]上海伊春六安兰州北京北方邦南京南宁南昌南通厦门合肥周口呼和浩特哥伦布唐山商丘大连天津太原威海安康山景城常州平顶山广州张家口张家界徐州成都扬州拉贾斯坦邦新布朗斯维克无锡昆明普赖恩维尔杭州桂林武汉汕头济南海口海得拉巴深圳漯河潍坊石家庄秦皇岛芒廷维尤芝加哥苏州荆门衡水衡阳衢州西宁西安贵阳运城遵义郑州重庆长春长沙韶关黄冈

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