未经证实:压力性溃疡(称为压力伤害)发生在骨性突出时,比如骶骨,受到长时间的压力,并可能导致软组织损伤。持续且专心的重新定位对于预防和治疗压力引起的伤口是必要的。
方法:一名49岁的患者因道路交通事故导致脊柱损伤后截瘫到医院就诊,严重感染骶骨褥疮,并抱怨全身无力和发烧。他的溃疡是15厘米*15厘米*8厘米,4年级。他接受了皮瓣重建,手术后转移到病房,开始静脉注射抗生素和镇痛。皮瓣血管化良好,没有感染或裂开的迹象。
未经评估:伤口管理始于对可改变因素的识别和积极管理,比如定位,失禁,痉挛,饮食,设备,和医学合并症,这有助于压力损伤的形成。最初的干预措施包括洗涤,清洁,并保持伤口的表面。在某些情况下,清除无活力或污染的组织可能就足够了。然而,在更严重的情况下进行操作护理或鼓励患者满意度可能是必要的。
结论:双叶皮瓣是治疗骶骨压力性溃疡的最佳技术。它有充足的血液供应。布局是简单和简单的。事实上,它具有低的并发症风险是至关重要的。应将其作为骶骨压力性溃疡局部皮瓣库的组成部分。
UNASSIGNED: Pressure ulcers (known as pressure injuries) occur when a bony prominence, such as the sacrum, is subjected to prolonged pressure and can result in soft tissue injury. Continuous and attentive repositioning is necessary to prevent and cure pressure-induced wounds.
METHODS: A 49-year-old patient who presented to the hospital with a
case of paraplegia post spinal injury due to Road Traffic Accident, with a huge infected sacral bed sore and complaints of generalized weakness and fever. His ulcer was 15 cm ∗ 15 cm ∗ 8 cm, grade 4. He underwent flap reconstruction, was post-operatively transferred into the ward, and started on IV antibiotics and analgesia. The flap is well vascularized with no signs of infection or dehiscence.
UNASSIGNED: Wound management begins with the identification and aggressive management of the modifiable factors, such as positioning, incontinence, spasticity, diet, devices, and medical comorbidity, which contribute to pressure injury formation. Initial interventions include washing, cleaning, and maintaining the surfaces of the wound. In certain cases, it may be sufficient to debride the non-viable or contaminated tissue. However, operational care in more severe cases or to encourage patient satisfaction may be necessary.
CONCLUSIONS: The bilobed flap is the best technique for healing sacral pressure ulcers. It has a plentiful supply of blood. The layout is uncomplicated and straightforward. The fact that it has a low risk of complications is crucial. It ought to be taken into account as a component of the local flap arsenal for sacral pressure ulcers.