摘要
目的探讨X-N推进皮瓣在臀部或背部压疮创面修复中的临床效果。方法2018年6月-2019年6月,广西医科大学第四附属医院创伤修复烧伤整形科收治20例臀部或背部Ⅳ级压疮患者,其中男15例、女5例,年龄48~89岁。患者创面清创后面积为8 cm×5 cm^15 cm×12 cm,采用笔者自行设计的X-N推进皮瓣进行修复。根据创面两侧皮肤松弛方向设计皮瓣,将皮肤X形切开后N形缝合。统计皮瓣宽度、推进距离,计算推进距离与皮瓣宽度比值,观察并记录皮瓣成活情况、并发症发生情况及随访情况。结果皮瓣宽度为(5.9±1.2)cm,皮瓣推进距离为(10.3±2.5)cm,皮瓣推进距离与皮瓣宽度比值为1.8±0.4。20例患者皮瓣全部成活,无一例皮瓣出现血运障碍。1例患者皮瓣于术后1周出现局部裂开,予上悬浮床、加强护理、创面换药后愈合;1例患者皮瓣术后5 d出现感染,予局部拆线引流,更换敏感抗生素后愈合;其余18例患者创面全部治愈。随访3个月,皮瓣存活良好,弹性、质地均较佳。结论X-N推进皮瓣可有效推进皮肤软组织,用其修复患者背部或臀部压疮操作简单、效果好,值得临床推广应用。
Objective To explore the clinical effect of X-N advancement flap in repairing pressure ulcer on the buttock or back.Methods From June 2018 to June 2019,20 patients with gradeⅣpressure ulcers on the buttock or back were hospitalized and treated in the Department of Traumatology,Burns and Plastic Surgery of Fourth Affiliated Hospital of Guangxi Medical University,including 15 males and 5 females,aged 48-89 years.The area of the patient′s wound was 8 cm×5 cm-15 cm×12 cm after debridement,and all were repaired with the X-N advancement flap designed by the author.The flap was designed according to the direction of skin relaxation on both sides of the wound,and the skin was incised in X-shape and sutured in N-shape.The width and advancement distance of the flap were recorded,and the ratio of the advancement distance to the width of the flap was calculated.The flap survival,complication,and follow-up were observed and recorded.Results The width of the flap was(5.9±1.2)cm,the advancement distance of the flap was(10.3±2.5)cm,and the ratio of the advancement distance to the width of the flap was 1.8±0.4.All the flaps survived,and none of the flaps had blood flow disorder.Local dehiscence occurred in the flap of one patient 1 week after surgery,which was healed after laying on the floating bed,strengthened care,and wound dressing change.The flap of one patient developed infection 5 days after surgery,which was healed after partial suture removal,smooth drainage,and replacement with sensitive antibiotics.The wounds of the remaining 18 patients were all cured.After 3 months of follow-up,the flaps survived well with good elasticity and texture.Conclusions The X-N advancement flap can make the skin and soft tissue move forward effectively.It is simple and effective to repair pressure ulcers on the back or buttock of patients with this flap,which is worthy of clinical promotion and application.
作者
崔泽龙
首家保
刘波
汪海涵
林阳洋
曾佳兴
龙照忠
陈英斌
张雪梅
Cui Zelong;Shou Jiabao;Liu Bo;Wang Haihan;Lin Yangyang;Zeng Jiaxing;Long Zhaozhong;Chen Yingbin;Zhang Xuemei(Department of Traumatology,Burns and Plastic Surgery,Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou 545005;Seventh Department of Plastic Surgery,Plastic Surgery Hospital of Chinese Academy of Medical Sciences,Beijing 100041;Department of Pathology,Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou 545005)
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2020年第6期476-479,共4页
Chinese Journal of Burns
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20191105、Z20191112)。
关键词
压疮
伤口愈合
X-N推进皮瓣
Pressure ulcers
Wound healing
X-N advancement flap
