携带淋巴管的游离皮瓣移植治疗肢体阻塞性淋巴水肿的应用解剖学研究

Applied Anatomy of Transfering "lymphatic Baring" Free Flap to Treat Obstructive Lymphedema of Extremities

目的为携带淋巴管的游离皮瓣移植治疗肢体阻塞性淋巴水肿提供解剖学依据和皮瓣设计思路。方法在16侧新鲜尸体上下肢上行普鲁士蓝-氯仿间接注射染色,解剖、观察浅集合淋巴管在前臂皮瓣和小腿内侧皮瓣供区的分布、走行。结果前臂皮瓣和小腿内侧皮瓣的供区内可供移植、吻合的浅集合淋巴管分布较稳定,能够保证设计尺寸为5.0cm×15.0cm的皮瓣内包含2条或2条以上的浅集合淋巴管。结论切取携带可供吻合的淋巴管的前臂皮瓣和小腿内侧皮瓣在解剖学上是可行的,皮瓣的设计要根据局部淋巴管的走行和分布灵活调整。

Objective To provide anatomic basis for transferring “lymphatic baring” free flap in the treatment of obstructive lymphedema of extremities. Methods On 16 adult cadaveric limbs, Prussian blue-CC14 was intradermally injected at the end of limb to show the course of lymphatic vessels, followed by antebrachial flap or lower medial leg fasciocutaneous flap dissection according to the distribution of lymphatic vessels. Results Lymphatic distribution in forearm and lower leg demon-strated that antebrachial flap or lower medial leg fasciocutaneous flap can include 2 or more collecting lymphatic vessels involved, which maximum area is 5.0 cm×15 cm. Conclusion It is feasible to design and harvest “lymphatic baring” ante-brachial flap or lower medial leg fasciocutaneous flap according to related applied anatomy.