Clinical efficacy of perforator-based bilobed flaps in treatment of stage 4 pressure ulcers
10.3760/cma.j.issn.1671-0290.2025.01.008
- VernacularTitle:基于动脉穿支的双叶皮瓣在4期压疮治疗中的应用效果
- Author:
Hangqing WU
1
;
Xilong ZHANG
1
;
Tao WANG
1
;
Jiaji DING
1
;
Songtao LI
1
Author Information
1. 徐州市第一人民医院烧伤整形与创面修复科，徐州 221116
- Publication Type:Journal Article
- Keywords:
Decubitus;
Bilobed flap;
Surgical flaps;
Artery perforator
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2025;31(1):42-46
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of perforator-based bilobed flaps in the treatment of stage 4 pressure ulcers.Methods:This retrospective observational study included 29 patients (21 males, 8 females) with stage 4 pressure ulcers admitted to the Department of Burn and Plastic Surgery and Wound Repair at Xuzhou First People's Hospital from August 2021 to May 2023. The patients' ages ranged from 12 to 82 (61.3±15.7) years. For ischial tuberosity pressure ulcers, reconstruction was performed using a posterior femoral bilobed flap based on the first perforator of the deep femoral artery, combined with a small gluteus maximus muscle flap. Sacrococcygeal pressure ulcers were repaired using a bilobed flap based on the superior or inferior gluteal artery perforator. Post-operative follow-up lasted for 2-36 months, during which flap survival and complications were assessed.Results:All the 29 bilobed flaps were successfully rotated and provided for adequate coverage without the need for pedicle division or perforator vessel dissection. Primary healing was achieved in 26 cases, with suture removal occurring two weeks post-operatively. Three patients experienced partial wound dehiscence and marginal necrosis due to post-operative pressure, which healed after two weeks of debridement and dressing changes. During follow-up for 2-36 months, no pressure ulcer recurrence was observed. The flaps demonstrated excellent survival, with soft texture, good elasticity, and adequate blood supply. The donor sites healed with only linear scars, and no severe complications were reported.Conclusion:Bilobed flaps based on artery perforators demonstrate excellent clinical outcomes in the treatment of stage 4 pressure ulcers.
