臂内侧皮瓣的显微血管

A STUDY OF MICROVASCULAR SUPPLY OF MEDIAL ARM FLAP

在30个肢体上观察了臂内侧皮瓣的血供及肱动脉的分支。肱动脉共发出分支386条,其中纯皮动脉有67支(17.36±1.93%),纯肌动脉及肌皮动脉共186支(48.18±2.54%),混合动脉133支(34.46±2.42%)。混合动脉包括肱深动脉、尺侧上副动脉及尺侧下副动脉。肱深动脉约于胸大肌下缘下2~3厘米处自肱动脉发出,口径平均值为2.22±0.14毫米,供应肱三头肌及臂内侧面上部和背面、外侧面的皮肤。尺侧上副动脉约于胸大肌下缘下6厘米处自肱动脉发出,口径平均为1.71±0.08毫米,供应肱三头肌长头、内侧头及臂内侧面中、下部的皮肤,主干长达5~7厘米,是臂内侧皮瓣的主要动脉。尺侧下副动脉约于胸大肌下缘下18厘米处自肱动脉发出,口径平均为1.50±0.07毫米,供应范围较小且偏下端。纯皮动脉的起点较分散,口径较小,平均为1.03±0.06毫米。肌皮动脉的数目虽较多,但只有肱二头肌肌皮动脉较粗大而恒定,约于胸大肌下缘下8厘米处自肱动脉发出,口径平均为1.63±0.13毫米,它发出的皮动脉粗细不一。皮动脉的吻合十分丰富,肉眼均可见到。皮瓣的静脉与动脉伴行,多为二条。

Thirty two upper limbs of 16 adult fresh cadavers were studied.Suspension ofbarium sulfate in red latex were injected prior to medial arm flap dissection.Thearm flaps were observed and measured under the magnifying spectacles(3X),and X-ray photographs were taken.The main results obtained are summarized as follows:1.In 30 specimens,there are 386 branches arising from the brachial artery——pure cutaneous branches(67,17.36±1.93%),pure muscular and myocutaneous branches(186,48.182±2.54%)and mixed branches(133,34.46±2.42%).2.The brachial profundal artery arises from the brachial artery about 2 to 3cm.below the lower margin of pectoralis major.The caliber of the artery is 2.22±0.14mm.It supplies the triceps brachii and the skin of medial and dorsal surfaceof the upper part of arm.3.The superior ulnar collateral artery arises from the brachial artery about 6cm,below the lower margin of the pectoralis major.The caliber of the artery is1.71±0.08mm.It supplies the long and medial head of Triceps Brachii and the skinof middle and lower part of arm.It is a main artery of medial arm flap.4.The inferior ulnar collateral artery arises from the brachial artery about 18cm,below the lower margin of pectoralis major.The caliber of the artery is 1.50±0.07mm.5.The myocutaneous artery of biceps brachii arises from the brachial arteryabout 8cm,below the lower margin of pectoralis major.The caliber of the artery is1.63±0.13mm.It gives off a larger cutaneous artery.6.An abundance of anastomoses is formed by these cutaneous arteries and arich network of arteries may be seen.The caliber of some of the cutaneous arteries isabove 1mm.7.The venous drainage consisted of venae comitants.The medial arm flap is generally thin,soft and non-hair-bearing,the caliberand length of the pedicles of the arteries are large enough for microsurgical vasoanas-tomosis.It is a suitable donor site for free transfer of skin flap and the optimaldimension is 8×20cm.