肩胛下血管蒂组织瓣的解剖及其临床应用

Anatomic study and clinical aplication of the compound subscapularis artery pedicled flap

目的 研究肩钾下血管蒂组织瓣的血供解剖 ,解决肩钾下血管蒂的联合组织瓣的临床应用。方法 采用 6具新鲜尸体标本 ,从肩胛下血管起始处灌注中华墨汁 ,观察皮肤着色范围 ,于背阔肌上缘、前缘、肩胛岗、腋前线和髂嵴平面分别切取组织块做连续切片 ,应用Luzex F图像分析仪 ,观察皮瓣间微血管构筑。结果 肩胛皮瓣、背阔肌肌皮瓣、侧胸皮瓣间存在非常丰富的血管吻合网。临床上以肩胛下动静脉为血管蒂 ,包含肩胛皮瓣、背阔肌肌皮瓣、侧胸皮瓣联合移植修复巨大软组织缺损 ,吻合血管移植 6例 ,轴型皮瓣移植 5 0例 ,均获成功。结论 肩胛下血管蒂联合组织瓣是一个理想的供区 ,可用于移植修复大范围组织缺损。

Objective To repair the massive soft tissue defect with the compound subscapularis artery pedicled flap on the basise of studing the anatomy of flap spaned multiple angiosomes.Methods Six fresh cadavers perfused with Chinese ink from the subscapularis artery,were dissected and observed the artery architecture,measured the density and area of vesseles network with imagine analysis in five regions:the superior and anterior of latissimus dorsi muscle,the scapulae spine,the anterior axillaris line and the iliac orista,respectively.Results Among the angiosomes of the circumflex scapularis artery,the thoracodorsalis artery and the lateral thoracic artery,there were abundant connective branches and anastomeses.Concolusion The compound subscaplaris artery pedciled flap has a pracitcal value in the repairing of the massive soft tissue defect.