二种窄蒂穿支型薄皮瓣及其附加血管吻合的扩大移植

Application of Narrow Pedicled Thin Flaps with Small Cutaneous Perforator and Vascular Anastomosis

目的 介绍枕颈部和肋间部两种窄蒂穿支型薄皮瓣的解剖、设计要点和应用经验。方法 以枕后动脉降支的皮穿支为蒂的枕颈部皮瓣根据其远端指向不同分为枕颈肩和枕颈背皮瓣。以４～９肋间动脉皮穿支为蒂的肋间穿支皮瓣可设计成斜型或垂直型。所有皮瓣的蒂宽均在３～５ｃｍ，瓣部宽大，同时远端还可继续加长携带旋肩仰血管或腹壁下深血管，使之形成巨大的薄皮瓣。结果 临床共应用５１例修复面颈手部，随访１个月至３年，功能与外形均满意。结论 该皮瓣主要优点是蒂窄便于旋转，有双套血供，巨大而薄，较适用于面、颈、手等外露部位的修复。

Objective To study the anatomy and application of two narrow pedicled thin (np - thin) flaps with small cutaneous perforator. Methods The np - thin occiptal cervical (oc) flap with the cutaneous perforator of occipital artery was formed by taking the distal part of flap at the shoulder area (OCS) or at dorsal area(OCD) . The np - thin intercostal flap was formed with 4th - 9th intercostal cutaneous perforator (ICP) . Both flaps can also be elongated by vascular anastomosis at its distal end. Results Fifty - one np - thin flaps were successfully used for reconstruction of skin defects in the neck, face and hand. Conclusions Flap with a narrow skin pedicle and thin distal part is useful for covering the hand and neck regions. It was proved to have better function and aesthetic results than the traditional methods.