跨区供血轴型皮瓣的形态学研究进展  

Research progress on morphology of the axial flap crossing vascular territories

作　　者：唐茂林[1] 刘元波 Tang Maolin;Liu Yuanbo(Department of Human Anatomy,Wenzhou Medical University,Wenzhou 325035,China;Scar Comprehensive Treatment Center,Plastic Surgery Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100144,China)

机构地区：[1]温州医科大学解剖学教研室,325035 [2]中国医学科学院北京协和医学院整形外科医院瘢痕综合治疗中心,100144

出　　处：《中华整形外科杂志》2020年第9期961-969,共9页Chinese Journal of Plastic Surgery

摘　　要：作者在文献复习与对比分析的基础上,应用轴型皮瓣及choke血管理论,探讨跨区供血皮瓣结合部的改造与重建,及其血流动力学特征。表明:(1)基于血管体区或穿支体区均可设计跨区供血皮瓣,其区别在于血管蒂与轴线;(2)如果各供区间的choke血管为端端吻合,呈串联排列,可获得超长皮瓣,而侧侧吻合呈并联排列,则可获超宽皮瓣;(3)Choke血管区的改造与重建可延长皮瓣轴线,使其转移距离和修复范围明显增大;(4)皮瓣切取范围可参考现有的解剖学资料及术前与术中检测综合评估。提出跨区供血皮瓣的choke血管区改造与重建,以及如何明确跨区切取范围与提高皮瓣远端成活率是目前的研究热点与难点。Based on the literature and comparative analysis reviewed,the authors applied the concept of axial pattern flap and choke vessel theory,discussed the transformation and reconstruction of the conjoined region of cross zone flap as well as its hemodynamic characteristics.Results:(1)Cross-zone flaps can be designed either based on the angiosomes or perforates.The difference lies in the pedicle and vascular axis.(2)A super-long flap could be achieved when the choke vessels of each donor site were arranged in series with end-to-end anastomosis,and a super-wide flap could be obtained if the chock vessels were arranged in parallel with side-to-side anastomosis.(3)The axis of the flap could be extended through the transformation and reconstruction of the chock vessel area,which significantly increased the reach of flap transfer and defect reconstruction.(4)The area of the flap that needs to be raised could be determined according to the existed anatomical literature and the comprehensive pre-and intra-operative evaluation.Conclusions:It is proposed that the transformation and reconstruction of the chock vessel area of the cross-zone flap,determination of the cross-zone flap area and promotion of the outcome of the distal part of the flap are all the current research hotspots and also bring challenges to both research and clinical work.

关 键 词：外科皮瓣 穿支皮瓣 整形外科 choke血管 

分 类 号：R622[医药卫生—整形外科]