摘要
目的解剖分析小腿部腓动脉穿支的穿出规律及各穿支血管之间的联系,为临床设计腓动脉双穿支皮瓣提供形态学基础。方法新鲜小腿标本8例行动脉灌注乳胶-氧化铅,对腓动脉各穿支血管解剖结构主要是血管的形态、走形、分布进行研究分析,筛选适合做双穿支皮瓣的血管蒂。临床上应用7例,均为吻合双血管蒂皮瓣,并逐渐扩大皮瓣切取面积,皮瓣大小:5cm×9cm^8cm×15cm。结果腓动脉直径≥5mm的穿支血管4~5支,其中以第2支穿支外径最粗,外径为(0.94±0.11)mm、血管蒂较长,蒂长为(6.61±1.32)cm、皮瓣血供面积较大适合作为首选穿支蒂再联合其他穿支设计双穿支皮瓣。7例双皮支腓动脉穿支皮瓣均成活,随访3~12个月,穿支皮瓣质地优良,外观及功能恢复较佳。结论设计以第2穿支联合其他穿支的腓动脉双穿支皮瓣,皮瓣轴心线位于穿支点后侧,临床上可切取血供佳、面积较大的腓动脉穿支皮瓣。
Objective To explore the anatomic characteristics of the perforators from the peroneal arteriess to provide morphological basis for design of flaps with double perforators from the peroneal artery. Methods Eight fresh lower limbs of human cadavers were injected with a modified mix of lead oxide and latex. The cutaneous perforator greater than 0.5 mm in diameter was dissected, recorded in dissection notes and photographed. The number of perforators, distance to fibular head, diameter and the length of the vascular pedicles were measured and analyzed. Perforators suitable for flaps with double perforators from the peroneal artery were identified. 7 cases with the skin defects were reconstructed with flaps with double perforators from the peroneal artery were identified, the size of the flaps ranged from 5 cmx 9 cm to 8 emx 15 cm. Results The number of perforators greater than 0.5 mm in diameter was 4 N 5. The second perforator was the largestone with a diameter of （0.94±0.1 1）ram and a pedicle length of （6.61 ± 1.32）cm. The second perforator could supply alarger area of skin and serve as the preferred pedicle for design of a flap with double perforators .Clinically, 7 free flaps survived , the flap is good in texture, satisfactory in appearance and functional recovery. Conclusions A larger flap with double perforators from the peroneal artery can be harvested safely with its pedicles based on the second perforator and any other one.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2014年第1期1-4,共4页
Chinese Journal of Clinical Anatomy
基金
广东省医学科研基金资助(A2013129)
关键词
腓动脉
穿支皮瓣
解剖学
移植
Peroneal artery
Perforator flap
Anatomy
Transplantation
