缝匠肌穿支皮瓣的应用解剖学研究

中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (3): 268-270.

缝匠肌穿支皮瓣的应用解剖学研究

孙锋¹，　黄东²，　吴伟炽²，　牟勇²，　马晓芬¹，　周绍龙¹

1.广东医学院研究生学院，广东湛江 524000；　2.广东省第二人民医院创伤外科，广州 510317

收稿日期:2012-01-20 出版日期:2012-05-25 发布日期:2012-06-06
通讯作者: 黄东，教授，主任医师，博士生导师，Tel:(020)89168086,E-mail:dong-177@163.com E-mail:sunfengqk@126.com
作者简介:孙锋（1985-），男，安徽亳州人，硕士研究生，住院医师，研究方向：创伤显微骨科
基金资助:
广东省科技计划项目（2010B031600114）

Applied anatomy of the sartorius perforator flap

SUN Feng¹, HUANG Dong², WU Wei-chi², MOU Yong², MA Xiao-fen²

1.Guangdong Medical College, Zhanjiang 524000; 2. Department of traumatic Surgery, the second People Hospital of Guangdong province, Guangzhou 510317,China

Received:2012-01-20 Online:2012-05-25 Published:2012-06-06

摘要/Abstract

摘要：

目的　明确缝匠肌肌皮动脉穿支和肌间隙穿支的分布区域特征，为缝匠肌穿支皮瓣的临床应用提供解剖学依据。方法　逐层解剖12侧经红色乳胶灌注的成人下肢新鲜标本，观察缝匠肌动脉血供特征、穿支数目及优势血管分布。结果　由各动脉发出进入缝匠肌及其表面皮肤的穿支血管有7~12支，其中以缝匠肌中、上段穿支分布较为集中，主要为股动脉发出。肌皮穿支有3~4支，平均管径(1.30±　0.15)mm，蒂长(1.10±0.10)cm；肌间隙穿支2~3条，管径(1.20±0.20)mm，蒂长(1.15±0.15)cm。此外，旋股外侧动脉发出一较长肌间隙穿支，管径(1.35±0.05)mm，蒂长(7.20±1.40)cm，可达缝匠肌中段。结论缝匠肌中、上段穿支较多而位置相对恒定，设计缝匠肌皮瓣游离移植修复组织缺损是切实可行的。

关键词: 缝匠肌, 穿支皮瓣, 应用解剖, 游离移植

Abstract:

Objective　To ascertain blood supply distribution of the sartorius perforators，including myocutaneous branches and direct cutaneous perforator, and provide anatomic basis for clinical application of sartorius perforator flap.　Methods　Twelve fresh unfixed corpses with red latex injection were dissected layer by layer. The distribution characteristics of dominant arteries of sartorius and the number of perforators were observed and analyzed. Results There were generally 7~12 perforating branches in sartorius muscle, from femoral artery, lateral femoral circumflex artery or descending genicular artery. The middle and inferior parts of sartorius received 3-4 myocutaneous perforators and 2-3 intermuscular space perforators originated from femoral artery, with the average external diameter of (1.7±0.6)mm, and the pedicle length of (2.8±1.2)cm. The perforators from the same origin were common.　Conclusions　Considering that perforating branches appeared in the lower part of sartorius muscle are abundant and constant, which is more feasible to design flap for tissue defect repair.

Key words: Sartorius, Pperforator flap, Applied anatomy, Free grafting

中图分类号:

R323.72

孙锋, 黄东, 吴伟炽, 牟勇, 马晓芬, 周绍龙. 缝匠肌穿支皮瓣的应用解剖学研究[J]. 中国临床解剖学杂志, 2012, 30(3): 268-270.

SUN Feng, HUANG Dong, TUN Wei-Chi, MAO Yong, MA Xiao-Fen, ZHOU Chao-Long. Applied anatomy of the sartorius perforator flap[J]. Chinese Journal Of Clinical Anatomy, 2012, 30(3): 268-270.

参考文献

[1] Blondeel PN, Van Landuyt KH, Monstrey SJ, et al. The “Gent” consensus on perforator flap terminology: preliminary definition
[j] .plast Reconstr Surg,2003, 112(5):1378-1383; quiz 1383,1516;discussion 1384-1387．

[2] 张世民,唐茂林,穆广态,等.穿支皮瓣及相关术语的专家共识
[J].中国临床解剖学杂志,2010,28(5):475-477．

[3] 唐茂林,卢书文,李忠华,等.股前内侧串联血管蒂肌皮瓣设计的解剖学基础
[J].中华显微外科杂志,2000,23(2):134-135．

[4] Rodriguez A, Alvarez A, Aguirrezabalaga J, et al. The anteromedial thigh flap as a training model of a perforator flap in rat
[J].J Reconstr Microssurg,2007,23(5):251-255．

[5] 林家福,郑和平,林涧,等.穿支皮瓣及相关术语的专家共识
[J].中国临床解剖学杂志,2010,28(5):475-477．

[6] 唐茂林,章为文,张世民,等.穿支皮瓣研究进展
[J].中国临床解剖学杂志,2011,29(6):602-603．

[7] 刘兴炎,文益民,葛宝丰,等.改进缝匠肌皮瓣逆行翻转修复小腿上端软组织缺损
[J].西北国防医学杂志,1991.12(3):43.

[8] 赵雁波,李志伟,刘海斌,等.缝匠肌皮瓣修复难治性胫骨上端创面
[J].实用手外科杂志,2010,24(3)227-288.

[9] Colwell AS，Donaldson MC，Belkin M，et al. Management of early groin vascular bypass graft infections with sartorius and rectus femoris flaps
[J]. Ann Plast Surg，2004,52:49-51.

[10] 杨晓东,丁茂超,梅劲,等.股前内侧穿支皮瓣的应用解剖学研究
[J].中国临床解剖学杂志,2011,29(6):624-628．

[11] Hupkens P, Van Loon B, Lauret GJ, et al. Anteromedial thigh flaps: an anatomical study to localize and classify anteromedial thigh perforators
[J].Microsurgery,2010,30(1):43-49．

[12] 王亦璁主编.骨与关节损伤
[M].第4版.北京:人民卫生出版社,2007.1159.

[13] 王华民,王钢,陈滨,等.青壮年新鲜股骨颈骨折的手术治疗
[J].中华创伤骨折杂志,2004,6(5):502-505．

[14] 穆希胜,王兰廷,杜鸿章,等.骨折再次内固定术后骨不连的手术治疗
[J].西北国防医学,2001,11(6):554-555.

[15] 徐栋华,张征宇,王靓洁.带逢降肌蒂髂骨瓣移植治疗髋穴骨缺损
[J].中国创伤骨科杂志,2001,3(2):109-110．

[16] 何尚宽,徐达传,钟桂午,等.隐血管蒂缝匠肌皮瓣的应用解剖学
[J].中国临床解剖学杂志,1996,14(2):111-114.

[17] 徐达传,张世民,唐茂林,等.穿支皮瓣的发展与现状
[J].中国修复重建外科杂志,2011,25(9):1025-1029．