手及前臂皮神经营养血管蒂皮瓣的应用解剖

Applied anatomy of cutaneous neurovascular flaps of hand and forearm

目的 观测手及前臂皮神经营养血管的情况 ,为设计以皮神经及其营养血管为蒂的岛状皮瓣提供形态学依据。方法 用红色氯仿油画染料灌注的 2 0侧成人上肢标本 ,在手术显微镜下解剖并观测手及前臂 5条皮神经营养血管的来源、数目、外径、穿出深筋膜的位置、与皮神经及浅静脉的关系等项目。结果 营养动脉多以降支方式伴行在皮神经深面内侧 ;前臂皮神经的血管网可达神经两侧各 2 .5cm范围内的皮肤。 5条皮神经的营养动脉外径接近。结论 手及前臂皮神经的营养血管血供可靠 。

Objective To observe the cutaneous nerve nutrient vessels at the hand and forearm for the design of the cutaneous neurovascular island flaps. Methods Twenty upper extremities of adult cadavers were perfused with the mixture of red chloroform and oil-paint. The origin, number, diameter and the point perforating the deep fascia of the 5 nutrient vessels, the relationship between nutrient vessels and cutaneous nerves and superficial veins were observed under surgical microscope. Results The nutrient arteries are mostly located at the deep medial side of cutaneous nerves, in a descending branches fashion. The cutaneous neurovascular network is distributed within 2.5 cm around both sides of the cutaneous nerves at the forearm. The 5 cutaneous nerve nutrient arteries are similar in diameters.Conclusions The cutaneous nerve nutrient at the forearm and hand can provide reliable blood supply,so the island flap can be designed at a corresponding location.