Application of local free-style perforator flap in repairing gluteal bedsores
10.3760/cma.j.cn114453-20191017-00310
- VernacularTitle:自由式局部穿支皮瓣在臀部褥疮修复中的应用
- Author:
Yuanming YANG
1
;
Xiancheng WANG
;
Xiang XIONG
;
Yang SUN
;
Xianxi MENG
;
Ying LIANG
;
Wenbo LI
;
Xiaofang LI
;
Fanglin ZENG
;
Yiming HU
;
Jinyuan CHANG
Author Information
1. 中南大学湘雅二医院烧伤整形外科，长沙 410011
- Keywords:
Pressure ulcers;
Surgical flap;
Perforate flap, free-style;
Reconstructive surgical procedures
- From:
Chinese Journal of Plastic Surgery
2020;36(5):531-535
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application of local free-style perforator flap in repairing gluteal bedsores.Methods:A retrospective study was performed. Date from 35 patients(20 males and 15 females, mean age 46 years old, range from 24-71) with gluteal bedsores between June 2017 and June 2019 were retrieved and reviewed by the Department of Burn and Plastic Surgery, Second Xiangya Hospital of Central South University. Among these cases, 13 were paraplegia after trauma, 6 were paralysis after cerebral hemorrhage, 13 were chronic infection, and 3 were poor wound healing after tumor resection. The average defect size was 5.6 cm×5.0 cm(range from 2.0 cm×3.0 cm to 10.0 cm×5.0 cm). By following the concept of free-style perforator flap, the flap was designed near the wound according to the perforator location detected by Doppler before surgery, and the defects were recovered by the flaps by rotation or other method such as rotation. Or the perforator flap can be modified into dermis-fat flap and flipped 180° to recover the wound. After the surgery, the survival of the flap or the dermis-fat flap, wound healing, as well as the sense and motion function of buttock and lower limbs were observed and recorded.Results:21 cases were repaired by perforator flap and 14 cases were repaired by modified dermis-fat flap. The size of flap range from 3.0 cm×3.0 cm to 10.0 cm×7.0 cm. The follow-up time was 3-22 months(mean, 12 months). All perforator flaps and dermis-fat flaps survived. The appearance of buttock was pleasant and no recurrence of bedsores. The patients without paraplegia had no major sensory loss and pain. The function of gluteus maximus was basically normal, and the motor function of lower limb was also generally satisfactory.Conclusions:The local free-style perforator flap or modified dermis-fat flap has advantages including simple design and operation, reliable blood supply and minimal damage to the donor site. It is a better way to repair gluteal bedsores.
