腹壁下动脉穿支皮瓣的局部解剖

Anatomy study of deep inferior epigastric artery perforator flap

目的探讨腹壁下动脉穿支皮瓣的解剖学基础及其在头颈修复中的临床意义。方法解剖国人新鲜成人尸体5具,观察并测量腹壁下深动脉穿支(deep inferior epigastric artery perforator,DIEAP)皮瓣供血穿支的数目、类型、管径、蒂长、走行、出筋膜后轴向及源血管外径并对其定位。结果腹壁下动脉穿支数目(>0.5mm)为124支,平均每侧(12.4±3.01)支,均为肌皮支。优势穿支的平均蒂长(14.5±3.13)cm,位置位于脐外6cm,脐上、下3cm之内。腹壁下动、静脉外径为(2.77±0.31)mm～(3.0±0.26)mm、(2.58±0.4)mm～(3.1±0.42)mm。结论DIEAP皮瓣穿支血管解剖位置较为恒定,其管径及蒂长均适宜头颈肿瘤术后缺损的修复。

OBJECTIVE To study anatomy of the deep inferior epigastric artery perforator flap （DIEAP） and explore its clinical application in reconstruction of head and neck defects. METHODS Five fresh cadavers were used, the morphosis and blood supply of deep inferior epigastric artery perforator flap were examined by microsurgery anatomy. The following parameters were recorded： number and type of perforator vessels, diameter, pedicle length, course （infra fascia and supra fascia） and location of perforator vessels, diameter of the original vessels. RESULTS There were 124 DIEAP musculocutaneous perforators （〉0.5 mm） medially in each specimen. The mean pedicle length of the perforator was （14.5±3.31） cm. Average diameter of deep inferior epigastric artery/vein was （2.77±0.31） mm～ （3.0±0.26） mm, （2.58±0.4） mm～ （3.1± 0.42） mm respectively. The largest perforator Iocats 6 cm laterally, and didn＇t exceed 3 cm from the umbilicus superiorly and inferiorly. CONCLUSION DIEAP flap is suitable for reconstruction of head neck defects because of its constant position, large caliber and long pedicle.