颈横动脉颈浅皮支轴型筋膜皮瓣临床应用

Clinical appilication of axial fascial flap with superficial branches of transverse cervical artery

目的寻求质地和色泽与颈面部皮肤相似,具有可切取的组织量大、一次转移完成的轴型筋膜皮瓣修复颌面颈部缺损的方法。方法在14例28侧尸体标本上从颈横动脉起始端注入红色乳胶,在直视放大镜和手术显微镜下追踪解剖观察颈横动脉颈浅皮支的走向和分布,发现其终末支在锁骨下胸前区、上臂前后外侧近3/5、项根部肩胛骨上缘范围内在深筋膜层与胸肩峰皮动脉、胸廓内动脉皮肤穿支有丰富的吻合形成广泛血管网。临床应用以颈浅皮支浅出点为旋转轴点,在上述范围内切取含完整深筋膜的轴型皮瓣,即时转移修复严重颈部瘢痕挛缩颌面颈缺损。结果临床应用93例,最大切取面积27×14cm,皮瓣完全成活,修复后外观形态良好,颌(颏)颈角逼真,功能恢复。结论以颈横动脉颈浅皮支为轴型血管,在颌面颈缺损邻近范围可切取足够组织量的筋膜皮瓣修复缺损。

Objective To find axial fascial flap which is abundant,can be transfered once and has similar texture and color with pate skin,for defection repairment of occlusalf surface and cervical part. Methods We injected red lactoprene from the beginning of transverse cervical artery in bilateral neck of 14 corpses,traced the direction and distribution of superficial branches by eyes,magnifier and microscope. We found the end branches form abundant vasoganglion with thoracic acromion skin artery and perforating branches of internal thoracic artery at deep fascia around infraclaviculal protothorax,3/5 proximal part of upper arm and collar area.We treated the out-point of superficial branches as rotation axial point,cutted hole fascial flap as the range mentioned adore to transfer and repair defection of cicatricial contracture in occlusalf surface and cervical part. Results Clinical appliications of 93 cases,the max cutting area was 27cm×14cm,all flaps alive with good appearance, angulus colli distinctly and function recovered. Conclusion Axial fascial flap with superficial branches of transverse cervical artery is abundant for defection repairment.