日本マイクロサージャリー学会会誌
Online ISSN : 2185-9949
Print ISSN : 0916-4936
ISSN-L : 2185-9949
症例
前内側大腿穿通枝皮弁による大転子部褥瘡の治療
高松 聖仁岡田 充弘上村 卓也榎本 誠香月 憲一中村 博亮
著者情報
キーワード: 皮弁, 穿通枝, 褥瘡, 大転子
ジャーナル 認証あり

2011 年 24 巻 4 号 p. 458-462

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 Recurrence of pressure sores remains a major challenge in surgical treatment. Recently the perforator flap has proven to be effective in the reconstruction of pressure sores in a variety of regions.
 We describe our experience using the proximal pedicled anterolateral thigh (ALT) flap in the treatment of trochanteric pressure sores.
 In this study, five ALT flap procedures were performed in 4 patients who had trochanteric pressure sores (NPUAP classification grade IV). They were 2 females and 2 males, and averaged 74.3 years old. In these patients, after the sores were debrided, pedicled ALT flaps were transferred to defects in trochanteric regions. After the operations, all of the flaps survived, with primary closure of the donor site. One flap had a superficial peripheral erosion that was treated conservatively. At the final follow up, there was no recurrence of pressure ulcers.
 Trochanteric coverage with the proximal pedicled ALT flap gave excellent results. The ALT flap has the following advantages: 1) reliability because of the pedicled flap, 2) good matching of thickness and skin texture, 3) less damage comparative to muscle flap, 4) primary closure of the donor site, and 5) simultaneous operations of debridement and flap elevation. We conclude that the ALT flap is a reliable alternative flap for trochanteric coverage.

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© 2011 日本マイクロサージャリー学会
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