The Gluteal Fasciocutaneous Rotation‐Advancement Flap with V‐Y Closure in the Management of Sacral Pressure Sores
The Gluteal Fasciocutaneous Rotation‐Advancement Flap with V‐Y Closure in the Management of Sacral Pressure Sores
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V-Y 闭合臀肌筋膜旋转推进皮瓣治疗骶管压疮
DOI：
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发表时间：
2002
影响因子：
3.6
通讯作者：
T. Maral
中科院分区：
文献类型：
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作者：
H. Borman;T. Maral
&NA;骶骨区是最常见的压疮发生部位之一，当需要手术闭合时，通常首选臀区的局部皮瓣。作者使用V-Y闭合的臀肌筋膜皮肤旋转推进皮瓣治疗15例患者的骶骨压疮。该设计结合了经典旋转和V-Y推进皮瓣模式。当伤口闭合时，通过皮瓣推进缓解旋转皮瓣远端的张力，并通过V-Y闭合侧向支持旋转-推进联合动作。皮瓣下内侧保留较宽的皮蒂。该蒂增加了皮瓣皮肤的血液供应，并保持手术切口较小，从而有助于降低粪便污染和相关伤口愈合问题的风险。这种皮瓣也可以转换为任何设计的筋膜皮肤或肌皮V-Y推进皮瓣，如果需要这样的变化。用单侧旋转推进皮瓣和双侧旋转推进皮瓣闭合的最大缺损直径分别为12 cm和18 cm。在1.5至35个月的随访中，没有患者发生需要重复手术的伤口裂开或皮瓣坏死。这种技术简单，可以快速执行，具有最小的相关发病率，并产生良好的结果。（Plast。重建109：2325，2002）。
&NA; The sacral region is one of the most frequent sites of pressure sore development, and local flaps in the gluteal region are usually preferred when surgical closure is needed. The authors used the gluteal fasciocutaneous rotation‐advancement flap with V‐Y closure to manage sacral pressure sores in 15 patients. The design was a combination of the classic rotation and V‐Y advancement flap patterns. When the wound was closed, the tension at the distal end of the rotation flap was relieved by flap advancement and the combined rotation‐advancement action was supported laterally with V‐Y closure. A wide skin pedicle was preserved at the inferomedial part of the flap. This pedicle augmented the blood supply to the flap skin and kept the surgical incision small, thus helping to reduce the risk of fecal contamination and associated wound‐healing problems. This flap can also be converted to any design of fasciocutaneous or musculocutaneous V‐Y advancement flap, should such a change be required. The largest defects that were closed with a unilateral rotationadvancement flap and bilateral rotation‐advancement flaps were 12 and 18 cm in diameter, respectively. In 1.5 to 35 months of follow‐up, none of the patients developed wound dehiscence or flap necrosis requiring repeated surgery. This technique is simple, can be performed quickly, has minimal associated morbidity, and yields a good outcome. (Plast. Reconstr. Surg. 109: 2325, 2002.)