CAJ | 학술논문

目的探讨与评价胭窝直接动脉穿支皮瓣的临床应用效果. 方法在30侧动脉内灌注红色乳胶的成人下肢标本上,解剖观测腘窝直接动脉穿支的起源、分支与吻合规律;设计腘窝直接动脉穿支皮瓣,并转位修复腘窝部软组织缺损7例. 结果胭窝直接动脉穿支于膝关节平面上7～11 cm处起于腘动脉上段后壁,经半腱肌与股二头肌间的肌腔隙(相当于腘窝上角)浅出,沿股后中线上升,其末端与股深动脉(第1～3穿动脉)皮穿支、闭孔动脉穿支和旋股外侧动脉皮穿支吻合.临床应用7例中,6例皮瓣全部成活,创面Ⅰ期愈合,1例因蒂部周围携带过多组织导致皮瓣血供不足,部分坏死,经换药等处理创面愈合.术后随访2～12个月,皮瓣质地优良,皮瓣及蒂部外型美观、不臃肿,膝关节伸屈基本正常. 结论腘窝直接动脉穿支解剖位置恒定、血液供应良好,手术方法简单,适用于修复腘窝、膝周软组织缺损.
목적 탐토여평개연와직접동맥천지피판적림상응용효과. 방법 재30측동맥내관주홍색유효적성인하지표본상,해부관측객와직접동맥천지적기원、분지여문합규률;설계객와직접동맥천지피판,병전위수복객와부연조직결손7례. 결과 연와직접동맥천지우슬관절평면상7～11 cm처기우객동맥상단후벽,경반건기여고이두기간적기강극(상당우객와상각)천출,연고후중선상승,기말단여고심동맥(제1～3천동맥)피천지、폐공동맥천지화선고외측동맥피천지문합.림상응용7례중,6례피판전부성활,창면Ⅰ기유합,1례인체부주위휴대과다조직도치피판혈공불족,부분배사,경환약등처리창면유합.술후수방2～12개월,피판질지우량,피판급체부외형미관、불옹종,슬관절신굴기본정상. 결론 객와직접동맥천지해부위치항정、혈액공응량호,수술방법간단,괄용우수복객와、슬주연조직결손.
Objective To investigate and evaluate the clinical effect of the direct popliteal artery perforator flap.Methods Thirty embalmed lower limbs of adult cadavers which perfused with red latex were used to dissection,major observations were the origin,perforators and anastomoses regulations of the direct popliteal artery.Based on the anatomical study,direct popliteal artery perforator flaps were designed and used clinically to 7 patients who had soft tissue defects in popliteal fossa.Results The direct popliteal artery perforator was direct started from lateral wall of the superior segment of popliteal artery,and about 7-11 cm above knee joint.Then it goes up along the middle line of posterior region of thigh,and pierced from the carvity between semitendinosus and biceps femoris and gave off several branches in superficial fascia.Finally,these branches anastomoses with many perforating branches which were gave off form deep femoral artery (the 1st to 3rd perforator artery),obturator artery and lateral circumflex femoral artery.Clinically,all flaps were survived eventually,and 6 of them were healed quickly,only 1 case needed to change dressings to healed its partial necrosis for the pedicle had too much soft tissues and too swelling to block its blood supply.After 2-12 months of following-up,the colors and appearances of these flaps were excellent,and the function of knees were nearly normal.Conclusion Direct popliteal artery perforator flap has relatively constant location and sufficient blood supply to use in clinical application,it is safe and easy to use for recovering soft tissue defects in popliteal fossa.