中国临床解剖学杂志 ›› 2014, Vol. 32 ›› Issue (1): 1-4.doi: 10.13418/j.issn.1001-165x.2014.01.001

• 应用解剖 •    下一篇

腓动脉双穿支皮瓣设计的解剖学分析与临床应用

牛国庆, 黄东, 吴伟炽, 黄国英, 欧阳海洋, 邓高丽   

  1. 南华大学教学医院广东省第二人民医院,  广州   510317
  • 收稿日期:2013-06-16 出版日期:2014-01-25 发布日期:2014-02-11
  • 通讯作者: 黄东,主任医师,博士生导师,E-mail:dong-177@163.com E-mail:newguoqing@yeah.net
  • 作者简介:牛国庆(1988-),男,山东临沂人,南华大学在读硕士生,研究方向:创伤修复与重建
  • 基金资助:

    广东省医学科研基金资助(A2013129)

An anatomic analysis and clinical study on design of the perforator flaps with double perforators from the peroneal artery

NIU Guo-qing, HUANG Dong, WU Wei-chi, HUANG Guo-ying, OUYANG Hai-yang, DENG Gao-li   

  1. NIU Guo-qing, HUANG Dong, WU Wei-chi, HUANG Guo-ying, OUYANG Hai-yang, DENG Gao-li
  • Received:2013-06-16 Online:2014-01-25 Published:2014-02-11

摘要:

目的 解剖分析小腿部腓动脉穿支的穿出规律及各穿支血管之间的联系,为临床设计腓动脉双穿支皮瓣提供形态学基础。  方法    新鲜小腿标本8例行动脉灌注乳胶-氧化铅,对腓动脉各穿支血管解剖结构主要是血管的形态、走形、分布进行研究分析,筛选适合做双穿支皮瓣的血管蒂。临床上应用7例,均为吻合双血管蒂皮瓣,并逐渐扩大皮瓣切取面积,皮瓣大小:5cm×9cm~8cm×15cm。  结果    腓动脉直径≥5mm的穿支血管4~5支,其中以第2支穿支外径最粗,外径为(0.94±0.11)mm、血管蒂较长,蒂长为(6.61±1.32)cm、皮瓣血供面积较大适合作为首选穿支蒂再联合其他穿支设计双穿支皮瓣。7例双皮支腓动脉穿支皮瓣均成活,随访3~12个月,穿支皮瓣质地优良,外观及功能恢复较佳。  结论    设计以第2穿支联合其他穿支的腓动脉双穿支皮瓣,皮瓣轴心线位于穿支点后侧,临床上可切取血供佳、面积较大的腓动脉穿支皮瓣。

关键词: 腓动脉, 穿支皮瓣, 解剖学, 移植

Abstract:

Objective To explore the anatomic characteristics of the perforators from the peroneal arteriess to provide morphological basis for design of flaps with double perforators from the peroneal artery. Methods Eight fresh lower limbs of human cadavers were injected with a modified mix of lead oxide and latex. The cutaneous perforator greater than 0.5 mm in diameter was dissected,  recorded in dissection notes and photographed. The number of perforators, distance to fibular head, diameter and the length of the vascular pedicles were measured and  analyzed. Perforators suitable for flaps with double perforators from the peroneal artery were identified. 7 cases with the skin defects were reconstructed with flaps with double perforators from the peroneal artery were identified. the size of the flaps ranged from 5 cm×9 cm  to  8 cm×15 cm. Results The number of perforators greater than 0.5 mm in diameter was 4~5. The second perforator was  the largestone with a diameter of (0.94±0.11)mm and a pedicle length of (6.61±1.32)cm. The second perforator could supply alarger area of skin and serve as the preferred pedicle for design of a flap with double perforators .Clinically, 7 free flaps survived , the flap is good in texture, satisfactory in appearance and functional recovery. Conclusions A larger flap with double perforators from the peroneal artery can be harvested safely with its pedicles based on the second perforator and any other one.

Key words: Peroneal artery, Perforator flap, Anatomy, Transplantation

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