改良双侧V-Y皮瓣治疗Ⅳ期骶尾部压疮的疗效分析

摘要 目的：探讨改良双V-Y皮瓣治疗Ⅳ期骶尾部压疮的有效性和安全性。方法：回顾性分析2015年3月-2019年3月中国人民解放军总医院第七医学中心骨科收治骶尾部压疮Ⅳ期患者28例，其中男15例，女13例，年龄49-65岁，创面面积6 cm×7 cm~8 cm×10 cm。彻底清创后设计改良双侧V-Y推移皮瓣覆盖创面并行负压封闭引流，皮瓣供区减张缝合，皮瓣面积6 cm×7 cm~8 cm×10 cm。术后观察皮瓣整体血运、温度、水肿情况及VSD引流量，定期通过门诊、微信、电话随访。结果：手术后双侧V-Y皮瓣全部成活，1例术后切口周边皮肤表皮坏死，经换药后愈合，28例患者全部获得随访，随访时间12-24个月，平均18.2个月，全部压疮缺损修复成功，无创口裂开、皮瓣淤血、水肿、感染及压疮复发。结论：改良双侧V-Y推移皮瓣是治疗Ⅳ期骶尾部压疮的一种有效治疗方法。

Clinical Effect Analysis of Modified Bilateral V-Y Flap in the Treatment of Stage IV Sacrococcygeal Pressureulcers

ABSTRACT Objective: To analyze the clinical effect and safety of modified bilateral V-Y flap in the treatment of stage IV sacrococcygeal pressureulcers. Methods: From March 2015 to March 2019, modified bilateral V-Y flap was used to treat stage IV sacrococcygeal pressureulcers. There were 15 males and 13 females with an average age of 54 years (range, 49-65 years) with a course of more than 6 months and poor efficacy of conservative treatment. All patients were treated by operation and repaired with modified bilateral V-Y flap. The healing rate and recurrence rate of flap were observed regularly after operation. Results: All the 28 patients were followed up for 12-24 months with an average of 13.2 months. All the wounds healed in the first stage after operation. Conclusion: The modified bilateral V-Y flap is an effective treatment for stage IV sacrococcygeal pressure injury.