[Combined treatment of refractory decubitus ulcers].

Objective: To summarize the clinical experience in the treatment of refractory decubitus ulcers.

Methods: From May 1998 to March 2005, 22 patients with decubitus ulcers (29 decubitus ulcers) were admitted, whose age was 36-92 years. The lesion size was 4 cm x 2 cm to 18 cm x 15 cm. The locations of decubitus ulcers were the sacrococcygeal region (18 cases), the tuber ischiadicus region (6 cases) and the trochanter major region (5 cases). Enteral nutrient was given orally and the wound was treated with Wuhuangyihao 8-15 days. Three diabetic patients were injected with insulin. According to patient's age, ulcer position, ulcer extent and ulcer degree, the flap type was determined. Three wounds were repaired by local flaps, the flap size was 6 cm x 4 cm-12 cm x 10 cm; 10 by fasciocutaneous flaps, 10 cm x 7 cm-20 cm x 17 cm; 9 by gluteus maximus myocutaneous flaps, 13 cm x 11 cm-17 cm x 14 cm; and 6 by long-head of biceps femoris flaps, 11 cm x 6 cm-14 cm x 7 cm. One was sutured directly. After operation, the patients were placed on airflow suspended bed 7-14 days.

Results: General nutritional status was improved, hemoglobin was greater than 100 g/L, albumen was greater than 30 g/L. Necrosis tissue was removed, granulation tissue turned into fresh, secretion reduced and no redness and swelling occurred in wound. All flaps survived and the wounds healed by first intention. After a follow-up of 6 months to 5 years, no patient had a recurrence, the color and texture of the flaps were good, the appearance was satisfactory.

Conclusion: Applying the technique of combined treatment can accelerate the healing of refractory decubitus ulcers and improves the success of operation.