浅谈薄型穿支皮瓣切取与穿支血管探测和皮瓣血运评估  

A brief discussion on the harvest of thinned perforator flap,detection of perforator vessels,and evaluation of flapbloodsupply

作　　者：张丕红[1] Zhang Pihong(Department of Burns and Plastic Surgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院烧伤整形外科,长沙410008

出　　处：《中华烧伤与创面修复杂志》2023年第10期911-918,共8页Chinese Journal of Burns And Wounds

基　　金：国家自然科学基金面上项目(81772084)。

摘　　要：修复重建不仅仅是对不同部位组织器官缺损的简单修复和再造, 更需要与缺损匹配、以假乱真的完美修复, 穿支皮瓣的薄型化策略就是其主要内容之一。近年来, 单纯皮肤穿支皮瓣理念及其临床应用颠覆了以往皮瓣必须携带真皮下血管网的传统观念, 拓展了人们对皮瓣外科的认知程度, 有望提高修复重建水平。该文针对穿支皮瓣的薄型化切取, 特别是最新的厚度类似于全厚皮的单纯皮肤穿支皮瓣的切取, 以及穿支血管的术前探测、穿支皮瓣的血运评估及其临床研究进行探讨, 提出与受区缺损完美匹配的"金缮"修复, 还对单纯皮肤穿支皮瓣的穿支体区和三维可视化数字解剖等研究进行了展望。Repair and reconstruction surgery is not just a simple repair and reconstruction of tissue and organ defects in different parts,but also requires perfect repair that matches the defect and confuses the real.The thinning strategy of perforator flap is one of its main contents.In recent years,the concept of pure skin perforator flap and its clinical application have overturned the traditional concept that flaps must carry subdermal vascular plexus and improved our understanding of flap surgery,and it is expected to enhance the level of repair and reconstruction.This article explores the harvest of thinned perforator flaps,especially the harvest of innovative pure skin perforator flap with the thickness similar to full thickness skin,as well as the preoperative detection of perforator vessels,blood supply evaluation of perforator flaps,and their clinical applications.It proposes a"Jinshan"repair that perfectly matches the recipient area defect,and also prospects research on the perforasome and three-dimensional visualized digital anatomy of pure skin perforator flaps.

关 键 词：穿支皮瓣 修复外科手术 薄型皮瓣 单纯皮肤穿支 术前血管成像 创面修复 

分 类 号：R61[医药卫生—外科学]