带腋毛穿支皮瓣的解剖学基础

Anatomical study of the axillary hair-bearing perforator flap

目的探讨腋窝穿支的解剖学特征,为临床阴阜软组织缺损的修复提供带毛皮瓣。方法选用30侧成人尸体标本15具(30侧),通过乳胶灌注、巨微解剖等方法,重点观测:①腋窝穿支血管的起源、分支与吻合;②腋窝穿支血管的外径与长度。结果腋窝底部皮肤有3种穿支:①胸背动脉第1皮支:出现率96.7%,起始外径(1.2±0.3)mm;②胸外侧动脉第1皮支:出现率90%,起始外径(1.2±0.2)mm;③腋动脉直接穿支:出现率93.3%,起始外径(1.4±0.3)mm。结论腋窝区皮肤血供丰富,解剖恒定,至少有一条皮穿支可遴选为血管蒂设计带毛穿支皮瓣,修复因肿瘤根治术后、烧伤、创伤等原因导致的带毛区皮肤缺损。

Objective To investigate the anatomical characteristics of the axillary fossa perforator,providing the hair-bearing perforator flap for reconstruction of the mons pubis defects.Methods 30 sides of adult cadaveric specimens were managed by methods of red latex perfusion,macro-micro-anatomy.The following contents were observed emphatically:①The origin,branches,and anastomosis of the axillary fossa perforators;②The outer diameter and length of the axillary fossa perforators.Results There were three types of perforating vessels in the axillary region:the first cutaneous perforator of the thoracodorsal artery(occurrence rate:96.7%),the first cutaneous perforator of the lateral thoracic artery(occurrence rate:90%),and the direct perforator of the axillary artery(occurrence rate:93.3%),with an average original outer diameter of(1.2±0.3)mm,(1.2±0.2)mm,and(1.4±0.3)mm,respectively.Conclusions Due to the rich blood supply and constant anatomy,there was at least one cutaneous perforator to be taken as the vascular pedicle for the design of a hair-bearing perforator flap in this axillary region,which could be a supplementary choice for repairing the hairy skin defects caused by tumor radical resection,burns,as well as trauma and other reasons.