- 期刊
以VY狀旋轉前移之闊筋膜張肌肌皮瓣治療肌骨粗隆褥瘡
The VY Rotation Advancement Tensor Fasciae Latae Myocutaneous Flap for Coverage of Trochanteric Pressure Sores
摘要
西元1989年，帕氏等人(paletta et al.)引進VY狀前移之闊筋膜張肌肌皮瓣，成功地治療股骨粗隆褥瘡。我們沿用帕氏的方法，並將皮瓣的後上端作向前、向上旋轉的設計。這項新的設計得以讓我們在應用此皮瓣時能完全利用到皮瓣所有的面積，同時減少皮瓣前移的程度，因而使皮瓣供應區作直接縫合時，在VY銜接處的張力減輕，連帶地將此部位皮膚壞死的機會降到最低，利用此VY狀旋轉前移之闊筋膜張肌肌皮瓣，我們成功地在11位病人身上治療了13處股骨粗隆褥瘡。術後，僅兩例出現皮瓣局部壞死的併發症：一是在皮瓣的後下緣；另一是在VY銜接處，經再一次的處理後傷口都癒合良好。追蹤1到19個月後所有的皮瓣都存活良好，沒有褥瘡復發的現象。
並列摘要
In 1989, Paleta et al. introduced the VY advancement tensor fasciae latae myocutaneous flap for trochanteric pressure sores coverage with good results. We modify the technique of Paletta et al by rotating the superior-posterior tip of the flap. This new design decreases the ranges of the flap advancement, minimizes the tension of the tip of the V flap and the chance of donor site skin necrosis at the junction of the VY advancement decreased after primary closure of the donor site. Using this VY rotation advancement of tensor fasciae latate flap, we successfully reconstructed 13 trochanteric pressure sores in 11 patients. Two minor complications were partial necrosis at the flap edge and flap tip, healed well after secondary intervention. There was no recurrence of the pressure sore during the follow-up period of one to 19 months. In our experience, the VY rotation advancement of tensor fasciae latae myocutaneous flap is a good option for the reconstruction of trochanteric defects with relatively low complication rate. It provides a good padding for the defect; it is technically easy; there is minimal dog-ear deformity; and the donor site can be closed primarily without skin graft. Meanwhile, if the pressure sore recurrs, the flap can be uterized for further advancement.