Clinical effect on treatment of Grade IV pressure sore around ischial tuberosity by a chimeric musculocutaneous flap pedicled with a perforator of superior gluteal artery
10.3760/cma.j.cn441206-20240628-00161
- VernacularTitle:臀上动脉穿支为蒂的嵌合肌皮瓣修复坐骨结节Ⅳ期压力性损伤的临床效果
- Author:
Jian ZHOU
1
;
Wei CHEN
1
;
Shusen CHANG
1
;
Zairong WEI
1
;
Kaiyu NIE
1
;
Fang ZHANG
1
Author Information
1. 遵义医科大学附属医院烧伤整形外科,遵义医科大学组织损伤修复与再生医学省部共建协同创新中心，遵义 563100
- Publication Type:Journal Article
- Keywords:
Pressure sore;
Musculocutaneous flap;
Superior gluteal artery perforator;
Ischial tuberosity;
Reconstruction of wound
- From:
Chinese Journal of Microsurgery
2025;48(2):167-172
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discusses the feasibility and clinical efficacy of the chimeric musculocutaneous flap pedicled with a superior gluteal artery perforator (SGAP) in treatment of Grade Ⅳ pressure sore around ischial tuberosity.Methods:A retrospective case study was conducted on 8 patients with Grade Ⅳ pressure sores around ischial tuberosity and treated in the Department of Plastic Surgery and Burns, the Affiliated Hospital of Zunyi Medical University from May 2019 to June 2023. The patients included 5 males and 3 females, aged 66.8 (40-78) years. All patients had paraplegia for 2 months to 10 years (mean, 59.2 months) and were complicated with hypoproteinemia. Two of the patients were also with sepsis. History of the Grade Ⅳ pressure sore was up to 1 month to 3.5 years (mean, 19.3 months). The sores were located on the right hip in 5 patients and left hip in 3 patients. The tissue defects of the pressure sore measured at 5 cm×5 cm to 6 cm×9 cm in size and all extended to the ischial tuberosity. Chimeric musculocutaneous flaps pedicled with a SGAP were used in the treatment of defect. The flap size ranged from 4 cm×8 cm to 7 cm×15 cm, and the muscular flap were at 8 cm×4 cm×2 cm to 14 cm×7 cm×5 cm in size. The muscular flaps were used to fill the cavities formed by the ulcer, while the flaps were used to cover the wounds. Donor and recipient site were sutured directly. The postoperative follow-ups were conducted at outpatient clinic and via telephone and WeChat interviews, and focused on evaluations of flap survival, complications, flap appearance and the recurrence of ulcer.Results:All the 8 flaps survived. All patients were included in the 3 to 16 months of postoperative follow-up, with 11.8 months in average. One flap had a partial edge split due to excessive pressure during negative pressure drainage, and healed after debridement and re-suture. Otherwise, the rest of 7 patients had primary healing at both the donor and recipient sites. All flaps had good appearance without ulceration, infection or recurrence of pressure sore.Conclusion:The chimeric musculocutaneous flap pedicled with SGAP offers a reliable blood supply, flexible rotation and sufficient tissue volume. It can be used to effectively reconstruct Grade Ⅳ pressure sore around ischial tuberosity with a reliable clinical effect.
