Lumbosacral rotation flap: a simple method for covering sacral pressure injuries.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-11-02 DOI:10.12968/jowc.2024.0271

Shavinder Dogra, Govind Menon, Jafar Husain, Sunil Anand

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Abstract

Background: Pressure injuries (PIs) are among the most common skin and soft tissue wounds occurring in patients who are bedbound and/or immobile. PI management hinges on their prevention; however, reoccurrence poses a challenge to their management and requires a multidisciplinary approach. Here, the authors describe a lumbosacral rotation flap (LSRF) for the coverage of sacral PIs.

Method: A single-centre, retrospective analysis of prospectively collected data was carried out. All patients undergoing LSRF for sacral PIs were included. Patients with active systemic sepsis, immune compromise, hepatic or renal dysfunction were excluded. All patients underwent preoperative optimisation and wound cultures to direct antibiotic therapy after surgery.

Results: A total of nine patients underwent the procedure (seven male and two female). Mean age was 47.6 years with a mean ulcer size of 92.9 cm². Bone biopsy indicated the presence of osteomyelitis in three patients. Of the LSRFs, two flaps showed minimal local complications in the form of marginal flap necrosis which was managed conservatively. All flaps healed well with no cases of flap loss or the need for secondary procedures.

Conclusion: The results of this analysis showed that LSRF can be considered a first line of treatment of sacral PIs. They can be used to cover large defects. Due to their large base and flap size, readvancement in cases of recurrence is also possible.

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腰骶部旋转皮瓣：一种覆盖骶骨压力损伤的简单方法。

背景：压迫性损伤（PIs）是卧床和/或行动不便的患者最常见的皮肤和软组织伤口之一。压迫性损伤的处理关键在于预防；然而，再次发生给压迫性损伤的处理带来了挑战，需要采用多学科方法。在此，作者介绍了一种用于覆盖骶骨PI的腰骶部旋转皮瓣（LSRF）：方法：对前瞻性收集的数据进行了单中心回顾性分析。方法：对单个中心收集的前瞻性数据进行回顾性分析，纳入所有接受 LSRF 治疗骶骨 PI 的患者。排除活动性全身败血症、免疫受损、肝肾功能障碍的患者。所有患者均接受了术前优化和伤口培养，以便术后直接使用抗生素治疗：共有九名患者接受了手术（七名男性，两名女性）。平均年龄为 47.6 岁，平均溃疡面积为 92.9 平方厘米。骨活检显示三名患者患有骨髓炎。在 LSRFs 中，有两个皮瓣出现了轻微的局部并发症，表现为边缘皮瓣坏死，采取了保守治疗。所有皮瓣愈合良好，没有皮瓣脱落或需要二次手术的病例：分析结果表明，LSRF 可被视为治疗骶骨缺损的一线方法。它们可用于覆盖大面积缺损。由于其基底大、皮瓣面积大，在复发的情况下也有可能重新植入。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.