颈胸部多源供血皮瓣的解剖及临床应用

Anatomy and clinical application of transcervi-cothoracic polyphyletic blood supply skin flap

作者应用颈胸部跨区供血皮瓣修复面颈部烧伤后瘢痕５６例，取得满意效果。局部解剖和临床应用证明：颈横动脉颈段皮支、胸廓内动脉肋间穿支和胸肩峰动脉皮支三组血管间有广泛的吻合。由于这种吻合支存在，故可设计跨区供血皮瓣来修复面颈部缺损。本组皮瓣以颈横动脉颈段皮支血管为蒂者３２例，以胸廓内动脉Ⅱ、Ⅲ穿支血管为蒂者２４例。手术结果表明不论蒂在上还是在内侧，胸前跨区供血皮瓣均能转移成功。

AbstractTranscervicothoracic skinnap was usedto repairthe faciocervical scars left after burns in 56 cases.Anatomy and clinical application proved that the trans-verse cervical artery branches out a constant skinartery before it enters the trapezius muscle and thisartery,after crossing the clavicle,is divided into twobranches,one extending outwards,and the otherdownwards .The internal thoracic artery branched outan intercostal perforator on the spot 1 cm to theparasternum. The perforator extended along the inter-costal plane and belonged to the direct skin artery,Therate for perforation between the second and third ribswas the highest and the diameter of the perforator thegreatest.The thoracoacromial skin artery perforatedthrough the medialsemis between the greater pectoralmuscle and the deltoid muscle, and extended towardthe shoulder,supplying the skin of the infraclavicular,deltoid and upper greater pectoral regions with blood;Anatomy and contrast examination showed that thereare extensive anastomoses between the three groups ofblood vessels.On the basis of these anastomoticbranches,transregional skin flaps can be designed torepair faciocervical damages. These flaps were success-fully used in the 56 cases,with 32 cases having the thebranch of cervical segment of the trasverse cervicalartery as the pedicle,and 24,the second and third per-fOrators of the internal thoracic artery as the pedicle.It was proved that the transregional flaps can be suc-cessfully transferred regardless of the sites of the pedi-cles.