腓动脉穿支为蒂的腓肠外侧皮动脉逆行岛状皮瓣的应用解剖

The reverse-flow lateral sural cutaneous artery island flap:anatomical study

采用25例突因外伤致死的健康成人新鲜下肢50侧,通过显微外科解剖、血管造影、染料试验等方法,探讨了本皮瓣的应用解剖学,其结论如下:腓肠外侧皮动脉出现率本组为100%,主要来源于腘动脉91.9%。其动脉末端在外踝上14.31±3.83cm 处与腓动脉穿支形成吻合弓,为本皮瓣的血供来源。吻合弓的出现率本组为88.64%,皮瓣最佳形成部位为小腿上段后外侧。

The circulatory pattern of a skin flap was studied by microsurgical dis- section,dye injection and angiography in 50 lower legs of fresh cadavers.The conclusions are as following: ①The lateral sural cutaneors artery descends constantly and superfi- cially accompanied by concomitant nerves.The upper post-lateral area of the lower leg in the best donor site of the flap.②The lateral sural cutaneous artery and the peroneal per- foratig artery form a anastomotic arcus around the lateral malleolus in 88.6% of the lower legs.The mean diameter of the anastomotic arcus is 0.63±0.19mm.③The peroneal perforating vessel is 3.5±1.4cm in length.Based on it the pedicle of the flap can be prolonged 6～8cm on the main vessel of the lateral sural cutaneous artery.④Cre- ation of the flap has no influence to the blood supply and function of the lower leg.⑤By anterograde transfer,the lateral sural island flap could be used to,repair the defects around the knee and upper tibia.However,retrograde transfer of the flap has a higher clinical values in repiring the defects on the lower one third of lower leg and medial malleolus.