轴型真皮下血管网皮瓣的应用解剖及在深度烧伤创面修复中的应用  

The applied anatomy of axial subdermal vascular network skin flap and its application in the management of deep burn wound

作　　者：肖添有[1] 肖能坎[1] 

机构地区：[1]第一军医大学珠江医院烧伤整形科,广州510282

出　　处：《中华烧伤杂志》2002年第6期336-338,共3页Chinese Journal of Burns

摘　　要：目的　为在深度烧伤创面修复中应用轴型真皮下血管网皮瓣 ,提供解剖学依据和临床经验。　方法　对 12例下肢标本进行解剖观察 ,重点观察股前外侧和隐血管轴型真皮下血管网皮瓣的轴心血管在浅筋膜层的走行、分支、真皮下血管网构筑和超薄范围等。对 2 6例四肢深度烧伤患者进行了轴型真皮下血管网皮瓣修复。　结果　以肌皮穿支为血供的股前外侧真皮下血管网皮瓣制备时 ,应采用“圆形”超薄法 ;以直接皮肤血管为血供的隐血管真皮下血管网皮瓣制备时 ,应采用“U形”超薄法。 2 6例患者皮瓣成活良好 ,经 0 .5～ 2 .5年随访 ,皮瓣色泽好 ,质地柔软 ,外形不臃肿 ,运动功能恢复良好。　结论　不同血供类型的轴型真皮下血管网皮瓣超薄方法不同 ;轴型真皮下血管网皮瓣具有明显的优点 。Objective To explore the anatomical basis and clinical application of axial subdermal vascular network skin flap (ASVNF) in the management of deep burn wounds. Methods Twelve samples of skin and subcutanenous tissue of lower extremities from adult cadavers were anatomically observed. The courser,branching and the architecture of the subdermal vascular network (SVN) in the super ficial facia and the ultra-thin area of the anterolateral femoral and saphenous axial subdermal vascular network skin flaps were intensively studied. The wounds in twenty-six patients with deep burn injury in the limbs were repaired with ASVNF. Results The circular thinning method was employed in the preparation of anterolateral femoral ASVNF whose blood supply was provided by the musculocutaneous perforators. And the 'U'shaped ultra-thin method was employed in the preparation of saphenous ASVNF, whose blood supply was directly provided by skin vessels. The flaps in these 26 patients survived very well in terms of the flap color, texture, contour and function after followed-up for 0.5～2.5 year. Conclusion Thinning methods for different kinds of ASVNF should be individulized. ASVNF might be an optimal choice in the management of deep burn wounds due to its obvious advantages.

关 键 词：轴型真皮下血管网皮瓣 应用解剖 创面修复 深度烧伤 

分 类 号：R644[医药卫生—外科学]