肌间隔血管源游离皮瓣的解剖学

AN ANATOMICAL STUDY OF FREE SKIN FLAPS SUPPLIED BY INTERMUSCULAR SEPTAL VESSELS

本文根据皮肤的血供规律,在传统的直接皮肤血管皮瓣、肌皮血管皮瓣和动脉干网状血管皮瓣三种类型基础上,提出一种新类型的肌间隔血管皮瓣。肌间隔皮肤动脉走行于肌间隔深面,容易分离,有较长的血管蒂,所供应的皮区均有部位适宜、质地优良的特点。本文在70例成人肢体和9个铸型标本上,研究了臂部和股部肌间隔的动脉,它们是:尺侧上副动脉、桡侧副动脉、第一穿动脉肌间隔枝、膝降动脉隐枝及其所供应皮区的应用解剖学。讨论了可供吻合血管游离皮瓣移植用的臂内侧皮瓣、臂外侧皮瓣、股后外侧皮瓣和小腿内侧皮瓣。

In addition to the three existing types of skin flaps,supplied by the cutaneous,the myocutaneous and the arterio-reticular vessels,a new type of free skin flap pedicled by the vessels of intermuscular septum was designed.The intermuscular septal arteries are easy to dissect and have relatively longer pedicles.The skin flaps taken from the limbs supplied by these arteries are suitable for grafting in their natural location.The intermuscular septal arteries of the arms and the thighs were studied and measured on 70 adult cadavers and 9 corrosion preparations.The arteries studied were:the superior ulnar collateral arteries,the intermuscular branches of the perforating arteries and the saphenous branches of the highest genicular arteries.The skin flaps supplied by these arteries were studied with regard to their application in surgery and these vessels were believed to be convenient for the microvascular anastomosis during grafting.The practical value of the skin flaps taken from the medial and lateral sides of the arm,the lateral side of the thigh and the medial side of the leg were discussed.