胸背动脉外侧支第一穿支皮瓣的解剖与应用  

Anatomy and Application of First Perforator Flap of Lateral Branch of Thoracodorsal Artery

作　　者：王爱武 杨壮群[1] 

机构地区：[1]西安交通大学第一附属医院整形外科,陕西西安710000

出　　处：《系统医学》2017年第11期71-73,共3页Systems Medicine

摘　　要：目的研究胸背动脉外侧支第一穿支的解剖走行、供血范围和临床应用。方法自2008年10月—2016年12月,对30例患者实施胸背动脉外侧支第一穿支皮瓣移植修复术,创面均为皮肤全层缺损并深部组织外露。皮瓣解剖不带背阔肌,不带胸背神经。游离移植25例,带蒂转移5例。修复头颈部创面6例,胸部2例,腋窝创面2例,四肢创面20例。创伤皮肤缺损13例,肿瘤创面7例,电烧伤及深度烧伤创面4例,瘢痕畸形创面4例,溃疡创面2例。皮瓣最小8 cm×5 cm,最大20 cm×12 cm。结果 30例皮瓣均完整解剖,胸背动脉外侧支第一穿支穿皮点位于肩胛下角水平线与背阔肌前缘内侧2 cm等弧线相交点附近2 cm范围内,较为恒定出现。皮瓣血供良好,移植后完全成活,创面均得到一期修复。供区均直接拉拢缝合。结论胸背动脉外侧支第一穿支皮瓣解剖较为恒定,解剖容易,皮瓣供血范围较大,血供良好,其源动脉—胸背动静脉血管管径较大,适合游离移植和带蒂转移。移植后的皮瓣不臃肿。供区较为隐蔽且多可直接缝合,切取后对背阔肌功能无影响。是理想的修复供区。Objective To research the anatomic delineation, blood supply range and clinical application of lateral branch of thoracodorsal artery. Methods From October 2008 to December 2016, 30 cases of patients were given the lateral branch of thoracodorsal artery flap graft repair, and the wound surface was the full-thickness skin defect and deep tissue exposure, and the flap anatomy had no lattissimus dorsi or nervus thoracodorsalis, and there were 25 cases with free grafting, 5 cases with pedicle skin graft, 6 cases with head and neck wound repair, 2 cases with chest repair,2 cases with axillary wound repair, 20 cases with limb wound repair, 13 cases with wound skin defect, 7 cases with tumor wound, 4 cases with electronic burning and deep burn wound, 4 cases with scar deformity wound repair and 2 cases with ulcer wound surface repair and the minimum flap and maximum flap were respectively 8 cm×5 cm and 20 cm×12 cm. Results The flaps of 30 cases were completely anatomized, and the skin penetration point of perforator flap of lateral branch of thoracodorsal artery lied in 2 cm range of cross-point of subscapular angle horizontal line and medial border 2cm arc of latissimus dorsi, and the blood supply of flaps was good and completely survived after graft, and the wound surface obtained the primary repair, and the supply area was suture directly. Conclusion The anatomy of first perforator flap of lateral branch of thoracodorsal artery is constant and simple, and the blood supply range of flap is big,and the vascular caliber of dorsal and thoracic arteriovenous is big, suitable for free grafting and pedunculated transfer,and the flap after grafting is not swelling, and the supply region is larvaceous and can be directly sutured, and has no effect on the latissimus dorsi function after removal, which is an ideal repair supply region.

关 键 词：胸背动脉外侧支 穿支皮瓣 解剖 移植 

分 类 号：R622.1[医药卫生—整形外科]