CAJ | 학술논문

目的报道吻合血管的腓动脉穿支蒂腓肠神经营养血管长轴皮瓣的应用解剖及其临床应用效果.方法 10侧下肢标本采用有色乳胶经腘动脉灌注,解剖观测腓动脉穿支血管的分布、走行及管径,寻找适合用于吻合血管的穿支血管.2007年4月至2010年1月,采用吻合血管的腓动脉穿支蒂腓神经营养血管长轴皮瓣游离移植修复前臂及手部大面积软组织缺损6例.缺损范围15 cm × 6 cm～45cm×10 cm.皮瓣面积为16 cm×8 cm～30 cm×10 cm,血管蒂长4～6 cm.结果腓动脉沿途平均发出5.3支穿支血管,在腓骨中下1/3交界处存在恒定的适合用于吻合血管的穿支血管,血管外径为(1.21±0.13)mm,血管蒂长(4.6±0.8)cm.6例皮瓣完全存活,随访3～12个月,皮瓣质地优良,外形与功能恢复满意.结论以腓动脉穿支为蒂的腓肠神经营养血管长轴皮瓣切取范围大,穿支血管蒂长,管径适中,血供可靠,对小腿功能影响小,是临床修复前臂及手部大面积软组织缺损的良好选择.
목적 보도문합혈관적비동맥천지체비장신경영양혈관장축피판적응용해부급기림상응용효과.방법 10측하지표본채용유색유효경객동맥관주,해부관측비동맥천지혈관적분포、주행급관경,심조괄합용우문합혈관적천지혈관.2007년4월지2010년1월,채용문합혈관적비동맥천지체비신경영양혈관장축피판유리이식수복전비급수부대면적연조직결손6례.결손범위15 cm × 6 cm～45cm×10 cm.피판면적위16 cm×8 cm～30 cm×10 cm,혈관체장4～6 cm.결과 비동맥연도평균발출5.3지천지혈관,재비골중하1/3교계처존재항정적괄합용우문합혈관적천지혈관,혈관외경위(1.21±0.13)mm,혈관체장(4.6±0.8)cm.6례피판완전존활,수방3～12개월,피판질지우량,외형여공능회복만의.결론 이비동맥천지위체적비장신경영양혈관장축피판절취범위대,천지혈관체장,관경괄중,혈공가고,대소퇴공능영향소,시림상수복전비급수부대면적연조직결손적량호선택.
Objective To report the anatomical study and clinical application of the free peroneal perforator-based sural neurofasciocutaneous flap. Methods Latex injection studies were performed on 10 adult cadaveric lower limbs. The presence, prevalence, and location of the peronel perforators that were suitable for vascular anastomosis were documented. From April 2007 to January 2010, 6 patients with large soft tissue defects in the upper limb underwent the reconstructive procedures with the free peroneal perforatorbased sural neurofasciocutaneous flap transfers. 4 patients were men and 2 were women, with the age ranging from 19 to 60 years. The causes of the injury included 4 motor vehicle accidents, and 2 massive machinery trauma. The area of the flap ranged from 16 cm × 8 cm to 30 cm × 10 cm, and the length of the perforator pedicle was 4 cm to 6 cm. Results A mean of 5.3 perforating vessels of the peroneal artery was noted in the specimen. The peroneal perforator that located at the junction of the middle and lower thirds of the fibula was found suitable for microsurgery, with the external diameter and the length being (1.21 ± 0.13)mm and (4.6 ± 0.8)cm respectively. All the 6 flaps survived completely without necrosis. No severe venous congestion was observed. All the patients were satisfied with the aesthetic outcome postoperatively at 3 to 12 months'follow-up. There were no major donor site complications. Conclusion The free sural neurofasciocutaneous flap based on a single peroneal perforator is an excellent tool for reconstruction of extensive soft tissue defects in the upper limb.