轴型血管蒂股前外侧真皮下血管网皮瓣的应用解剖

Applied anatomy of anterolateral femoral subdermal vascular network flap pedicled with axial-pattern artery

在１２侧灌注颜料的新鲜下肢上，解剖观察了以旋股外侧动脉降支为蒂的股前外侧真皮下血管网皮瓣血供、真皮下血管网的构筑及静脉回流，结果显示：①皮动脉穿出深筋膜后随即分成２～６支主要分支各自斜行浅筋膜途中发出浅筋膜分支、真皮下血管网分支和混合型三种分支；②真皮下血管网分支在真皮下层形成“血管树”或“蜘蛛痣”状吻合稠密的血管网；③在制备股前外侧真皮下血管网皮瓣时需保留血管蒂周围２．５ｃｍ不超薄，其余周边部分超薄至保留皮下脂肪２～３ｍｍ；④真皮下静脉也吻合成网，通过皮动脉伴行静脉或股外侧浅静脉回流。文中讨论了皮瓣的血供特点和优点。

The blood supply,arterial architecture and venous drainage of the subdermal vascular network skin flaps in anterolateral femoral region,which are pedicaled with the descending branch of lateral circumflex femoral artery,were observed on 12 fresh lower limbs of adult cadaver specimens perfused with latex and black ink.We found the cuteneous artery divides into 2～6 main branches after perforated the deep fascia,and 3 types of branches were given off from the main branches on their way to superficial fascia,i.e.superficial branch,subdermal vascular network (SVN) branch and mixture branch.Each SVN branch formed a 'tree'of 'spider nevus'arterial network,which anastomosize densely in subdermal.Whe the anterolateral femoral SVN flap was cutting,at least 2.5 cm thick flap was needed aroune the pedicle and 2～3 mm fat should be reserved on the other part of the flap.The subdermal veins anastomosize in plexus and drain into the accompanying veins of the cuteneous artery or into the lateral femoral superficial vein.The character of blood supply and the advantages of the flap were discussed.