PEDICLED SUPERIOR GLUTEAL ARTERY PERFORATOR BILATERAL QUADRILOBED FLAPS FOR REPAIR OF LARGE SACROCOCCYGEAL PRESSURE SORES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HAI Henglin ¹ , LI Huatao ¹ , CHEN Yang ² , LI Qiang ¹ , WU Shenggang ¹ , WANG Lili ¹ , YAN Lei ¹ , ZHOU Xiaoying ¹

1Department of Burns and Plastic Surgery, 2Department of Dermatology, the 98th Hospital of Chinese PLA, Huzhou Zhejiang, 313000, P.R.China. Corresponding author: HAI Henglin, E-mail: xyp_79@163.com;

Corresponding author：

Keywords：

Sacrococcygeal pressure sore; Superior gluteal artery perforator; Quadrilobed flap; Wound repair

DOI：

10.7507/1002-1892.20130071

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Objective To investigate the effectiveness of pedicled superior gluteal artery perforator bilateral quadrilobed flaps for repairing large sacrococcygeal pressure sores. Methods Between June 2003 and August 2011, 6 paraplegia patients with large sacrococcygeal pressure sores were repaired with the pedicled superior gluteal artery perforator bilateral quadrilobed flaps. There were 2 males and 4 females with an average age of 45.6 years (range, 37-62 years). The mean disease duration was 8.4 months (range, 3-26 months). According to National Pressure Ulcer Advisory Panel (NPUAP) standard, 6 cases rated as degree IV. The size of pressure sores ranged from 15 cm × 13 cm to 18 cm × 16 cm. The size of flaps ranged from 18 cm × 14 cm to 21 cm × 15 cm. Results After operation, all flaps survived successfully. The wounds healed by first intention in 5 cases; partial dehiscence of incision occurred in 1 case, which was cured after dressing change for 26 days. Six patients were followed up 6-24 months (mean, 12.5 months). The appearance and texture of the flaps were smooth and soft with good elasticity and no ulceration. Conclusion Pedicled superior gluteal artery perforator bilateral quadrilobed flaps can repair large sacrococcygeal pressure sores. The appearance of flaps is smooth and has good compression-resistance effect.

Citation： HAI Henglin,LI Huatao,CHEN Yang,LI Qiang,WU Shenggang,WANG Lili,YAN Lei,ZHOU Xiaoying. PEDICLED SUPERIOR GLUTEAL ARTERY PERFORATOR BILATERAL QUADRILOBED FLAPS FOR REPAIR OF LARGE SACROCOCCYGEAL PRESSURE SORES. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(3): 308-311. doi: 10.7507/1002-1892.20130071 Copy

1.	Koshima I, Moriguchi T, Soeda S, et al. The gluteal perforatorbased flap for repair of sacral pressure sores. Plast Reconstr Surg, 1993, 91(4): 678-683.
2.	Verpaele AM, Blondeel PN, Van Landuyt K, et al. The superior gluteal artery perforator flap: an additional tool in the treatment of sacral pressure sores. Br J Plast Surg, 1999, 52(5): 385-391.
3.	Lee JT, Hsiao HT, Tung KY, et al. Gluteal perforator flaps for coverage of pressure sores at various locations. Plast Reconstr Surg, 2006, 117(7): 2507-2508.
4.	Meltem C, Esra C, Hasan F, et al. The gluteal perforator-based flap in repair of pressure sores. Br J Plast Surg, 2004, 57(4): 342-347.
5.	王先成, 李晓芳, 鲁青, 等. 臀上或臀下动脉穿支皮瓣修复臀部褥疮. 中华整形外科杂志, 2010, 26(2): 113-115.
6.	周忠志, 黄新灵, 舒巍, 等. 臀部穿支皮瓣在褥疮修复中的应用. 中国美容医学, 2010, 19(8): 1127-1129.
7.	傅荣, 杜丽平, 游晓波, 等. 臀部穿支皮瓣治疗高龄患者骶尾部褥疮的疗效. 中国修复重建外科杂志, 2011, 25(5): 562-564.
8.	傅荣, 游晓波, 杜丽平. 臀部穿支皮瓣结合负压封闭引流治疗骶尾部褥疮. 中华显微外科杂志, 2012, 35(3): 236-237.
9.	侍德. 骨科修复重建手术学. 上海: 上海医科大学出版社, 2001: 143-144.
10.	王泠. 压疮的管理(一). 中国护理管理, 2006, 6(1): 62-64.
11.	刘毅, 张绪生, 张诚, 等. 褥疮的临床分型及手术治疗原则. 中国修复重建外科杂志, 2007, 21(9): 932-936.
12.	徐永清, 朱跃良, 李军, 等. 臀上皮神经营养血管皮瓣转位修复骶尾部褥疮. 中华显微外科杂志, 2011, 34(1): 29-30.
13.	查选平, 林勇, 张彩明, 等. 应用臀上皮神经营养血管皮瓣修复骶尾部褥疮13例的体会. 中华损伤与修复杂志(电子版), 2012, 7(1): 74-76.
14.	许喜生, 马铮铮, 周永生, 等. 重度褥疮的临床治疗经验. 中华整形外科杂志, 2011, 27(6): 405-410.
15.	Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle. Br J Plast Surg, 1989, 42(6): 645-648.
16.	Brondal PN, Van Landuyt K, Hamdi M, et al. Perforator flap terminology: update 2002. Clin Plastic Surg, 2003, 30(3): 343-346.
17.	董栋, 章伟文, 魏鹏. 穿支皮瓣的发展及最新进展. 医学综述, 2012, 18(7): 1057-1059.
18.	Murakami M, Hyakusoku H, Ogawa R. The multilobed propeller flap method. Plast Reconstr Surg, 2005, 116(2): 599-604.
19.	Xu Y, Hai H, Liang Z, et al. Pedicled fasciocutaneous flap of multi-island design for large sacral defects. Clin Orthop Relat Res, 2009, 467(8): 2135-2141.
20.	胡斯旺, 戴开宇, 梅劲, 等. 臀区穿支皮瓣的应用解剖学研究. 中国临床解剖学杂志, 2006, 24(3): 243-246.
21.	Ahmadzadeh R, Bergeron L, Tang M, et al. The superior and inferior gluteal artery perforator flaps. Plast Reconstr Surg, 2007, 120(6): 1551-1556.
22.	于冶, 贾立平. 臀骶部褥疮皮瓣修复进展. 中华烧伤杂志, 2010, 26(5): 405-406.
23.	Ay A, Aytekin O, Aytekin A, et al. Interdigitating fasciocutaneous gluteal V-Y advancement flaps for reconstruction of sacral defects. Ann Plast Surg, 2003, 50(6): 636-638.
24.	童仁联, 黄峻, 钟晓旻, 等. 臀大肌远侧穿支V-Y皮瓣修复骶部褥疮. 中国修复重建外科杂志, 2006, 20(12): 1208-1210.
25.	Leow M, Lim J, Lim TC. The superior gluteal artery perforator flap for the closure of sacral sores. Singapore Med J, 2004, 45(1): 37-39.
26.	海恒林, 戴海华, 许月萍, 等. 难治性褥疮的综合治疗. 中国修复重建外科杂志, 2006, 20(9): 909-911.
27.	海恒林, 戴海华, 华云飞, 等. “五黄一号”治疗复杂褥疮临床疗效观察. 东南国防医药, 2005, 7(5): 334-335.
28.	钟贵彬, 侯春林. 脊髓损伤后弛缓性膀胱的治疗. 中国修复重建外科杂志, 2005, 19(8): 673-675.

1. Koshima I, Moriguchi T, Soeda S, et al. The gluteal perforatorbased flap for repair of sacral pressure sores. Plast Reconstr Surg, 1993, 91(4): 678-683.
2. Verpaele AM, Blondeel PN, Van Landuyt K, et al. The superior gluteal artery perforator flap: an additional tool in the treatment of sacral pressure sores. Br J Plast Surg, 1999, 52(5): 385-391.
3. Lee JT, Hsiao HT, Tung KY, et al. Gluteal perforator flaps for coverage of pressure sores at various locations. Plast Reconstr Surg, 2006, 117(7): 2507-2508.
4. Meltem C, Esra C, Hasan F, et al. The gluteal perforator-based flap in repair of pressure sores. Br J Plast Surg, 2004, 57(4): 342-347.
5. 王先成, 李晓芳, 鲁青, 等. 臀上或臀下动脉穿支皮瓣修复臀部褥疮. 中华整形外科杂志, 2010, 26(2): 113-115.
6. 周忠志, 黄新灵, 舒巍, 等. 臀部穿支皮瓣在褥疮修复中的应用. 中国美容医学, 2010, 19(8): 1127-1129.
7. 傅荣, 杜丽平, 游晓波, 等. 臀部穿支皮瓣治疗高龄患者骶尾部褥疮的疗效. 中国修复重建外科杂志, 2011, 25(5): 562-564.
8. 傅荣, 游晓波, 杜丽平. 臀部穿支皮瓣结合负压封闭引流治疗骶尾部褥疮. 中华显微外科杂志, 2012, 35(3): 236-237.
9. 侍德. 骨科修复重建手术学. 上海: 上海医科大学出版社, 2001: 143-144.
10. 王泠. 压疮的管理(一). 中国护理管理, 2006, 6(1): 62-64.
11. 刘毅, 张绪生, 张诚, 等. 褥疮的临床分型及手术治疗原则. 中国修复重建外科杂志, 2007, 21(9): 932-936.
12. 徐永清, 朱跃良, 李军, 等. 臀上皮神经营养血管皮瓣转位修复骶尾部褥疮. 中华显微外科杂志, 2011, 34(1): 29-30.
13. 查选平, 林勇, 张彩明, 等. 应用臀上皮神经营养血管皮瓣修复骶尾部褥疮13例的体会. 中华损伤与修复杂志(电子版), 2012, 7(1): 74-76.
14. 许喜生, 马铮铮, 周永生, 等. 重度褥疮的临床治疗经验. 中华整形外科杂志, 2011, 27(6): 405-410.
15. Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle. Br J Plast Surg, 1989, 42(6): 645-648.
16. Brondal PN, Van Landuyt K, Hamdi M, et al. Perforator flap terminology: update 2002. Clin Plastic Surg, 2003, 30(3): 343-346.
17. 董栋, 章伟文, 魏鹏. 穿支皮瓣的发展及最新进展. 医学综述, 2012, 18(7): 1057-1059.
18. Murakami M, Hyakusoku H, Ogawa R. The multilobed propeller flap method. Plast Reconstr Surg, 2005, 116(2): 599-604.
19. Xu Y, Hai H, Liang Z, et al. Pedicled fasciocutaneous flap of multi-island design for large sacral defects. Clin Orthop Relat Res, 2009, 467(8): 2135-2141.
20. 胡斯旺, 戴开宇, 梅劲, 等. 臀区穿支皮瓣的应用解剖学研究. 中国临床解剖学杂志, 2006, 24(3): 243-246.
21. Ahmadzadeh R, Bergeron L, Tang M, et al. The superior and inferior gluteal artery perforator flaps. Plast Reconstr Surg, 2007, 120(6): 1551-1556.
22. 于冶, 贾立平. 臀骶部褥疮皮瓣修复进展. 中华烧伤杂志, 2010, 26(5): 405-406.
23. Ay A, Aytekin O, Aytekin A, et al. Interdigitating fasciocutaneous gluteal V-Y advancement flaps for reconstruction of sacral defects. Ann Plast Surg, 2003, 50(6): 636-638.
24. 童仁联, 黄峻, 钟晓旻, 等. 臀大肌远侧穿支V-Y皮瓣修复骶部褥疮. 中国修复重建外科杂志, 2006, 20(12): 1208-1210.
25. Leow M, Lim J, Lim TC. The superior gluteal artery perforator flap for the closure of sacral sores. Singapore Med J, 2004, 45(1): 37-39.
26. 海恒林, 戴海华, 许月萍, 等. 难治性褥疮的综合治疗. 中国修复重建外科杂志, 2006, 20(9): 909-911.
27. 海恒林, 戴海华, 华云飞, 等. “五黄一号”治疗复杂褥疮临床疗效观察. 东南国防医药, 2005, 7(5): 334-335.
28. 钟贵彬, 侯春林. 脊髓损伤后弛缓性膀胱的治疗. 中国修复重建外科杂志, 2005, 19(8): 673-675.

Chinese Journal of Reparative and Reconstructive Surgery

PEDICLED SUPERIOR GLUTEAL ARTERY PERFORATOR BILATERAL QUADRILOBED FLAPS FOR REPAIR OF LARGE SACROCOCCYGEAL PRESSURE SORES

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