腹壁下动脉穿支皮瓣的应用解剖及临床  

Clinical anatomy and application of the free inferior epigastric artery transverse rectus abdominis myocutaneous flap

作　　者：张莉[1] 董佳生[2] 戴传昌[2] 林晓曦[2] 王炜[2] 

机构地区：[1]蚌埠医学院附属医院修复重建外科,安徽蚌埠233004 [2]上海第二医科大学附属第九人民医院整形外科,上海200011

出　　处：《蚌埠医学院学报》2006年第1期27-29,共3页Journal of Bengbu Medical College

摘　　要：目的:改进和完善下腹部横行腹直肌(transverse rectus abdom in is myocutaneous,TRAM)肌皮瓣乳房再造术式。方法:将TRAM瓣改进为保留腹直肌及其前鞘的下腹部横行腹壁下动脉穿支(deep inferior ep igastric perforator,D IEP)皮瓣用于乳房再造4例,并复习文献阐述其优点。结果:皮瓣全部成活,不仅再造了乳房,同时又有腹壁整形的效果,患者满意。结论:该皮瓣具有TRAM瓣的所有优点,又避免了腹部并发症;D IEP瓣的大小、厚薄、血管蒂的长短应用都有很大的灵活性,从而大大拓宽了临床应用范围。Objective： To improve the techniques of harvesting the free inferior epigastrie artery transverse rectus abdominis myoeutaneous （TRAM） flap on the basis of the anatomic studies. Methods：We performed breast reconstruction for four patients after mastectomy with this deep inferior eplgastric perforator （DIEP） flap, sparing the whole rectus abdominis muscle, and preserving adequate abdominal wall competence. We also reviewed related literature and discussed its advantages. Results：This flap had all the advantages inherent in TRAM flap breast reconstruction and the donor site morbidities were avoided. The variety of the dimension and thickness of the flap and the length of its pedicle increased its flexibility in clinical application. Conclusions： DIEP flap can repair various defects as required. As it spares the whole rectus abdominis muscle, it has minimal insult to the abdominal wall and has the effect of abdominoplasty for middle-aged women. The application of this kind of flap represent the direction of plastic surgery＇ s development.

关 键 词：乳腺/外科手术 外科皮瓣 乳房再造 解剖学 局部 

分 类 号：R655.8[医药卫生—外科学] R622[医药卫生—临床医学]