Clinical effect of negative pressure closed drainage combined with gluteus maximus myocutaneous flap
preserving superficial branch of superior gluteal artery in the repair of stage IV sacrococcygeal pressure sore
XIA Weidong, TU Zhuolong, ZHAO Sheng, MIU Aimei, LIU Zhengjun, LIN Cai.
National Key Clinical Specialty (Wound Healing), Burn and Wound Healing Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China
XIA Weidong,TU Zhuolong,ZHAO Sheng, et al. Clinical effect of negative pressure closed drainage combined with gluteus maximus myocutaneous flap
preserving superficial branch of superior gluteal artery in the repair of stage IV sacrococcygeal pressure sore[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(4): 318-322.
Abstract：Objective: To investigate the clinical effect of negative pressure closed drainage combined with gluteus maximus rotary musculoflap preserving the superficial branch of superior gluteal artery in the repair of sacrococcygeal pressure sore. Methods: A total of 12 patients with sacrococcygeal pressure sore from the First Affiliated Hospital of Wenzhou Medical University from June 2019 to October 2023 were selected, including 7 males and 5 females, aged 31-86 years old. After admission, the wound was repaired with a gluteus maximus myocutaneous flap preserving the superficial branch of the superior gluteus artery 4-7 days later. The survival an complications of the skin flap were observed. The shape of the skin flap and the recurrence of pressure sore were observed. Results: All the 12 patients in this group developed stage Ⅳ pressure sores due to long-term bedridden sacrococcygeal compression. The causes of pressure sores included paraplegia in 5 patients and long-term bedridden for various reasons in 7 patients including 2 patients with cerebral infarction sequela, 3 patients with
Parkinson’s disease, 1 patient with Alzheimer’s disease, and 1 patient with femoral neck fracture. The course of disease ranged from 2 weeks to 8 years, and the wound area after debridement ranged from 5.0 cm×5.0 cm to 10.0 cm×12.0 cm. All the 12 cases were completely alive after operation, and there was no flap necrosis, venous congestion or wound border cracking. After 2-6 months of follow-up, the flap shape was good, the sacrococcygeal soft tissue full, and the pressure sore did not recur. Conclusion: The gluteus maximus rotator myocutaneous flap with preservation of the superficial branch of the superior gluteal artery has reliable blood supply, simplein design and operation. The flap has a large repair area, and it does not need to cut off the superficial branch of the superior gluteal artery, and the donor site can generally be sutured directly, thus having an excellent effect in
repairing sacrococcygeal pressure ulcer.
