腓动脉穿支跨区供血的腓肠神经营养血管逆行岛状皮瓣的解剖和临床应用  

Vascular anatomy and clinical applications of the distally based superficial sural artery island flap

作　　者：杨大平[1] 方冬云[1] 郭铁芳[1] 韩雪峰[1] 

机构地区：[1]哈尔滨医科大学第二附属医院整形外科,150086

出　　处：《中华整形外科杂志》2004年第1期24-26,共3页Chinese Journal of Plastic Surgery

摘　　要：目的　观察小腿皮肤腓浅动脉与腓动脉穿支之间的吻合联系 ,设计以腓动脉穿支为蒂的岛状皮瓣。方法　 10具新鲜尸体 2 0侧肢体血管灌注氧化铅—明胶混合液 ,通过X线片显示小腿皮肤内的血管结构和血管之间的吻合。在此基础上应用了跨区供血的腓动脉穿支蒂逆行岛状皮瓣 2 6例。结果　解剖研究表明小腿腓肠神经营养血管主要来自腓浅动脉。在外踝后上方 4～ 7cm处腓动脉穿支与腓浅动脉或动脉网形成广泛吻合。以腓动脉穿支为蒂设计包含腓肠神经及其伴行的腓浅动脉和小隐静脉的返流岛状皮瓣 2 6例 ,皮瓣全部成活。结论　跨区供血的腓动脉穿支为蒂的岛状皮瓣 ,为修复小腿远端及足跟部软组织缺损提供了一种简单有效的方法。Objective To document the vascular anatomy of the distally based superficial sural artery flap and to study the vascular anastomoses between the superficial sural artery and the septocutaneous perforators of the peroneal artery. Methods Ten fresh human cadavers were injected with lead oxide, gelatin and water. Twenty lags were then dissected and an overall map of the cutaneous vasculature was constructed. Vascular communications between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery was evaluated to determine the cutaneous vascular territory of the superficial sural flap. The distally based superficial sural artery island flap was used in 26 cases. Results There is constant vascular anastomosis between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery. The 26 flaps survived uneventfully except for two of partial fat necrosis. Conclusion The anatomic information enhances our understanding of flap design.

关 键 词：腓动脉 供血 小腿 临床应用 吻合 腓肠神经营养血管逆行岛状皮瓣 皮肤 解剖研究 明胶 混合液 

分 类 号：R622.1[医药卫生—整形外科] R687.2[医药卫生—外科学]