小隐静脉栓塞对腓肠神经营养血管逆行皮瓣的影响

目的 探讨小隐静脉栓塞对小隐静脉-腓肠神经营养血管蒂逆行岛状皮瓣的影响.方法 于30只大白兔小腿后侧切取小隐静脉-腓肠神经营养血管蒂逆行岛状皮瓣,随机分为3组,每组10个皮瓣,第1组在蒂部保留小隐静脉干;第2组在蒂部远端1 cm将小隐静脉干结扎;第3组在蒂部远端1 cm栓塞小隐静脉干.结果 第1组皮瓣的小隐静脉充盈较第2、3组显著,且第1组皮瓣均有明显淤血、肿胀.第3组皮瓣存活率(87.5%)明显高于第1组(62.3%)和第2组(81.5%),差异均具有统计学意义(P＜0.01).结论 在小隐静脉远端栓塞或结扎阻断静脉血流灌人,均能显著提高远端蒂皮瓣的存活率;但在蒂部结扎小隐静脉影响皮瓣远端供血和皮瓣成活面积.     

浅静脉干不同处理方法对远端带蒂皮瓣影响的实验研究

目的　探讨浅静脉干用不同处理方法后对远端带蒂皮瓣的影响。方法　将 2 0只新西兰大白兔建立成远端带小隐静脉腓肠神经筋膜蒂的岛状皮瓣动物模型。按手术先后随机分为 4组 ,每组 10个皮瓣。第 1组在蒂部保留小隐静脉干 (流入 ) ;第 2组在蒂部远端 1cm将小隐静脉干结扎 (阻断 ) ;第 3组在近端重新吻合小隐静脉干 (流出 ) ;第 4组仅在皮瓣表面切开 (渗出 )。结果　第 1、4组的小隐静脉压力较第 2组显著增高 ,且超过毛细血管动脉压。皮瓣存活率第 3组 (94.5 % )与第 1组 (2 2 .7% ) ,第 2组(5 5 .5 % )和第 4组 (2 4.0 % )相比 ,差异有非常显著意义 (t =8.77、10 .2 7、P <0 .0 0 1)。第 2组较第 1、4组皮瓣的存活率明显要高 (t =3 .70、2 .82 ,P <0 .0 1)。结论　在近端重建浅静脉流出通道或在远端阻断浅静脉血流灌入 ,均能显著提高远端蒂皮瓣的存活率     

远端蒂腓肠神经营养血管皮瓣静脉回流的解剖与临床对比研究

目的探讨在腓肠神经营养血管皮瓣的远端蒂部结扎小隐静脉改善静脉回流的解剖学基础及其临床效果。方法通过对17具成人尸体34条小腿标本小隐静脉解剖研究,对11例远端蒂腓肠神经营养血管皮瓣于外踝尖上2．5cm、外踝后缘1．5cm处结扎小隐静脉(组2),与早期40例未在远端蒂部结扎小隐静脉(组1),就皮瓣瘀血肿胀及成活情况进行对比。结果小隐静脉于外踝尖上(2．5±0．4)cm、外踝后缘(1．4±0．2)cm汇合成小隐静脉干;于外踝尖上(3．5±0．5)cm发出一浅深静脉交通支。临床40例未在远端蒂部结扎小隐静脉(组1),15例(37．5%)出现明显的静脉瘀血和肿胀,5例(12．5%)有张力性水疱发生;而11例结扎小隐静脉(组2),2例(18．2%)出现一定程度瘀血和肿胀,无水疱出现。结论外踝尖上2．5cm、外踝后缘1．5cm结扎小隐静脉,能有效改善腓肠神经营养血管皮瓣的肿胀及成活质量。     

小隐静脉栓塞在腓肠神经营养血管逆行皮瓣应用

目的探讨小隐静脉栓塞在腓肠神经营养血管逆行皮瓣的临床疗效。方法本组87例施行腓肠神经营养血管逆行皮瓣修复,A组30例在蒂部远端栓塞小隐静脉,B组57例未栓塞小隐静脉,测量统计两组病例术后皮瓣坏死面积占皮瓣总面积的百分比。结果小隐静脉栓塞病例皮瓣坏死面积为1.1%,小隐静脉未栓塞病例皮瓣坏死面积为15%,两组皮瓣坏死面积比较差异具有统计学意义(P0.01)。结论小隐静脉栓塞方法减少了皮瓣的逆行血流灌注和坏死的并发症,显著提高腓肠神经营养血管逆行皮瓣的成活率。     

小隐静脉-腓肠神经营养血管皮瓣的临床研究

目的　报道远端蒂及近端蒂小隐静脉 腓肠神经营养血管皮瓣修复下肢软组织缺损的效果。　方法　采用近端蒂及远端蒂、带腓肠神经或不带腓肠神经的小隐静脉 腓肠神经营养血管皮瓣 ,修复 2 5例小腿胫前近、中、远段和踝周、足背及足跟皮肤缺损 ,皮瓣最小面积为 5cm× 4cm ,最大面积为10cm× 15cm。　结果　 2 5例中远端蒂皮瓣 2 2例 ,近端蒂 3例 ,不带腓肠神经的皮瓣 3例 ,皮瓣全部成活 ,皮瓣质地优良 ,外观及功能满意。　结论　该皮瓣可行近、远端蒂转移 ,皮瓣可带或不带腓肠神经 ,均有足够的血运。本皮瓣成活率高 ,操作简便 ,不牺牲主干血管 ,是修复小腿胫前、踝周及足跟部软组织缺损的理想皮瓣。     

腓肠神经营养血管皮瓣修复足踝部软组织缺损的疗效分析

目的应用腓肠神经营养血管皮瓣修复足踝部软组织缺损,探讨不同的小隐静脉处理方法对皮瓣成活率的影响。方法应用腓肠神经营养血管皮瓣修复足踝部软组织缺损29例29足;切取皮瓣面积:7 cm×6cm～12 cm×8 cm;皮瓣血管蒂长8～17 cm,蒂宽3～4 cm。结果皮瓣移位后小隐静脉不处理组2例、远端结扎组2例发生了静脉危象,经保守治疗后,各有1例出现约1/4皮瓣坏死;而静脉剥离组和静脉吻合组均无静脉危象和皮瓣坏死现象发生。皮瓣全部成活。29例均获随访,时间4个月～3年,皮瓣色泽、弹性均正常,无臃肿,外观良好,踝关节功能基本正常。大部分恢复了保护性感觉,两点辩别觉为12～16 mm。结论腓肠神经营养血管皮瓣血运良好,手术操作简便、安全,可有效修复足踝部皮肤软组织缺损。     

应用腓肠神经营养血管皮瓣修复踝足部软组织缺损

目的报道应用腓肠神经营养血管蒂逆行岛状筋膜皮瓣修复踝足部软组织缺损的临床效果。方法临床应用4种术式，1组：既不结扎蒂部小隐静脉，又不吻合向心性静脉11例；2组：吻合向心性回流静脉10例；3组：结扎蒂部小隐静脉13例；4组：既结扎蒂部小隐静脉又吻合向心性回流静脉13例。结果1组11例中术后1个月内有5例出现明显肿胀，有3例皮瓣远端边缘部分坏死，有2例半年后皮瓣臃肿。2组、3组、4组术后1个月皮瓣肿胀分别是3例、3例和1例。皮瓣出现部分坏死分别为1例、1例和0例。半年后皮瓣臃肿分别是1例、1例和0例。结论第4组的临床效果优于前3组。     

小腿浅静脉皮神经皮瓣修复足远端创面

目的探索大隐静脉-隐神经营养血管皮瓣和小隐静脉-腓肠神经营养血管皮瓣修复同侧足远端创面。方法临床应用13例修复足远端创面,以踝上3～5cm作为旋转点,保留2cm皮肤及3～4cm筋膜蒂,保护链状血管连续性,明道真皮下潜行分离形成隧道,旋转点以三角瓣覆盖并总结皮瓣成活的规律及形成系列方法。结果 13例皮瓣均成活,其中1例远端1.5cm出现暗红,经拆线减张、换药后愈合。结论隐神经、腓肠神经及大隐静脉、小隐静脉周围均有血管网伴行,大隐静脉-隐神经营养血管皮瓣、小隐静脉-腓肠神经营养血管皮瓣形成远端蒂移位修复小腿或中后足部创面,也可修复同侧足远端创面。皮瓣血运可靠,不牺牲主要血管,是小腿及全足部创面的良好供区。     

腓肠神经营养血管逆行岛状皮瓣的临床应用

目的　应用腓肠神经营养血管逆行岛状皮瓣修复同侧小腿下段及足踝部软组织损伤的临床效果。方法　应用腓肠神经营养血管逆行岛状皮瓣修复同侧小腿下段及足踝部软组织损伤 19例 ,皮瓣面积最大 15cm× 13cm ,最小 5cm× 4cm。其中将小隐静脉与受区静脉吻合 9例 ,未吻合但在其蒂部结扎 6例 ,未吻合也未结扎 4例。结果　大部皮瓣成活 ,小隐静脉吻合者皮瓣全部成活 ,未吻合但在其蒂部结扎者部分坏死 1例 ,未吻合也未结扎者均短期内间内肿胀淤血且大部分坏死 1例。结论　腓肠神经营养血管逆行岛状皮瓣是修复小腿及足踝部软组织缺损的可靠方法 ,术中若能将小隐静脉与修复区静脉吻合其效果更佳。     

腓肠神经营养血管远端蒂皮瓣小隐静脉的应用解剖

目的研究腓肠神经营养血管远端蒂皮瓣小隐静脉营养血管的来源。方法30侧动脉灌注红色乳胶成人下肢标本,以外踝尖为观测指标点,在其上10cm范围内,显微解剖观测远端蒂中的小隐静脉营养血管来源、分布与皮肤血管的关系,以及小隐静脉浅深交通支。结果由远及近,远端蒂部的小隐静脉营养血管来源于跟外侧动脉穿支、外踝后动脉穿支和腓动脉肌间隔穿支。上述动脉穿支2～5支,外径0.6～1.0mm,发深筋膜支、神经静脉营养支和皮支,形成深浅筋膜血管网、腓肠神经干血管链、小隐静脉旁血管链以及静脉壁血管网。小隐静脉浅深交通支1～2支,外径1.7±0.5mm,距外踝尖上3.4±0.9cm,汇入腓静脉。结论远端蒂的腓肠神经、小隐静脉筋膜及皮肤的营养血管同源。外踝尖上3～4cm处存在小隐静脉浅深交通支,远端蒂皮瓣旋转点设计于此处,有助于改善皮瓣静脉回流。     

Comparison of different managements of large superficial veins in distally based fasciocutaneous flaps with a veno-neuro-adipofascial pedicle: an experimental study using a rabbit model

The role of large superficial veins in the survival of a distally based fasciocutaneous flap with a veno-neuro-adipofascial pedicle was studied in a rabbit model. A sural veno-neuro-fasciocutaneous flap model (6 x 2 cm) with a distally based lesser saphenous veno-neuro-adipofascial pedicle (1.5 cm) was established. Fifteen rabbits were randomly divided into three groups with 10 flaps in each group. In group I, the distal lesser saphenous vein was left open (venous inflow remained) after the flap was raised. In group II, the lesser saphenous vein was ligated in the pedicle (no venous inflow). In group III, the venous pedicle was left open in the pedicle, and the proximal end was microsurgically anastomosed to the recipient vein (outflow established). Intravenous pressure, flap survival, and histology were examined. The results showed that the values of intravenous pressure in group I were significantly higher than in group II (P < 0.001). The mean flap survival rate of group III (94.5%) was significantly higher (P < 0.001) than of groups I (22.7%) and II (55.5%). Histology showed that the lesser saphenous vein in group I was extremely dilated and filled with thrombosis. This experiment demonstrated that establishing a superficial venous outflow channel by anastomosis at the proximal end, or interrupting the inflow channel by ligation at the distal pedicle, may significantly improve the survival rate of distally based veno-neuro-fasciocutaneous flaps.     

结扎伴行静脉对逆行岛状皮瓣存活的影响

目的 以新西兰大白兔隐动静脉逆行岛状皮瓣为实验模型,探讨结扎血管蒂伴行静脉干对逆行岛状皮瓣存活的影响.方法 将10只新西兰大白兔两侧后肢左右随机分为2组,每组10个皮瓣,进行同体对照.建立隐动静脉逆行岛状皮瓣实验模型(面积3 cm×3 cm,血管蒂长4 cm,血管蒂周围保留1 cm宽筋膜).对照组:血管蒂部不做任何处理;实验组:在放大10倍手术显微镜视下于血管蒂的两端分别结扎伴行静脉干,使2根伴行静脉干完全闭塞.术后每天观察皮瓣颜色、肿胀情况.术后1周测皮瓣成活率,并切取血管蒂进行组织学观察.结果 术后两组皮瓣均有较明显的肿胀,实验组皮瓣肿胀更为明显.两组皮瓣平均成活率比较,对照组为(92.7±12.1)%,实验组为(46.8±38.3)%,差异有统计学意义(t=3.61,P＜0.01).两组皮瓣蒂部均可见扩张的微血管,高度肿胀导致坏死的皮瓣,在其蒂部扩张的微血管内可见血栓形成.结论 血管蒂的伴行静脉结扎使皮瓣更易发生静脉危象,导致皮瓣坏死.微血管内血栓形成可能是导致皮瓣静脉回流障碍的又一重要因素.

Abstract：

Objective To evaluate the effect of ligating venae commutantes in the pedicle on the survival of reverse-flow island flaps. Methods Ten New Zealand rabbits were used. Reverse flow island flap based on the saphenous artery and vein was created on both hind limbs,with a total of 20 flaps. The size of the flap was 3 cm×3 cm with a 4 cm long vascular pedicle containing 1 cm strip of connective tissue. These flaps were randomly divided into 2 groups of 10 flaps each. In group Ⅰ,the vascular pedicle (1 saphenous artery and 2 venae commutantes) was raised and its sheath was not disturbed,maintaining communicating and collateral branches intact. In group Ⅱ,the 2 venae commutantes were ligated with 8-0 suture at both ends of the pedicle under 10X microscope and the connective tissue was maintained intact. The color and congestion of flaps were observed daily. Flap survival rate was measured after one week. The vascular pedicle was harvested and observed histologically. Results The flaps began to appear obviously swelling after blood oozing stopped. The extent of swelling was more severe in group Ⅱ than in group Ⅰ. Flap survival rate of group Ⅰ (92.7±12.1)% was significantly higher than that of group Ⅱ (46.8±38.3)% (t=3.61,P<0.01). Histological examination revealed lots of dilated venules in the vascular pedicle. The amount of dilated venules in group Ⅱ was more than that in group Ⅰ. Lots of thrombi could be seen in the dilated venules in the pedicle of completely or partially necrotic flaps. Conclusion Venous crisis takes place more easily in flaps without venae commutantes,resulting in flap necrosis. The venous thrombosis may be the other important influencing factor for necrosis of reverse-flow flaps.     

腓肠神经营养血管远端蒂皮瓣修复足踝部软组织缺损

目的：总结应用腓肠神经营养血管远端蒂皮瓣修复足踝部皮肤软组织缺损的经验。方法：从2006年2月～2008年12月,笔者应用腓肠神经营养血管远端蒂皮瓣修复足踝部软组织缺损共12例,皮瓣最大15cm×10cm,最小6cm×5cm,筋膜蒂宽度为4～5cm,皮瓣旋转点至外踝尖距离5～7cm。皮瓣剥离的深度在腓肠肌肌膜深面,将小隐静脉和腓肠神经包含于内。蒂部均留有2cm宽度的皮肤,走明道向受区旋转。结果：12例皮瓣全部成活,无供血不足及静脉回流障碍。结论：腓肠神经营养血管远端蒂皮瓣血运丰富,制作简便,防止蒂部受压是成活率高的保证。     

足部大面积皮肤软组织缺损的皮瓣修复临床分析

目的:比较足部大面积皮肤软组织缺损应用不同类型皮瓣(小腿主干血管逆行皮瓣、皮神经营养血管逆行皮瓣和游离皮瓣)修复的临床效果。方法:57例足部大面积皮肤软组织缺损的患者清创后,应用不同类型的皮瓣进行修复,并比较其成活面积、观察其疗效。其中,小腿主干血管逆行皮瓣14例,面积:7～9cm×11～20cm,平均:8cm×16cm,采用胫后动脉逆行皮瓣3例,腓动脉逆行皮瓣11例;皮神经营养血管逆行皮瓣26例,面积:7～9cm×9～15cm,平均:8cm×11cm,采用腓肠神经营养血管逆行岛状皮瓣23例,隐神经营养血管逆行岛状皮瓣3例;游离皮瓣17例,面积:9.5～15cm×12～28cm,平均:12cm×25cm,采用股前外侧皮瓣13例,隐动脉皮瓣3例,胸背动脉皮瓣1例。结果:57例皮瓣中,完全坏死2例,部分坏死7例,其余全部成活。坏死者全部涉及前足皮肤缺损,其中,主干血管逆行皮瓣完全坏死1例,部分坏死2例;皮神经营养血管逆行皮瓣远端部分坏死5例;游离皮瓣完全坏死1例。统计学分析:皮瓣面积按类型比较(ANOVA),P=0.000,差异有非常显著性意义;皮瓣成活率按类型比较(Kruskal-Wallis Test),P=0.455,差异无显著性意义。经3～18个月随访,所有成活皮瓣血运、外形、质地、功能均满意。结论:大部分足部大面积皮肤软组织缺损可选用皮神经营养血管逆行皮瓣进行修复,但如果涉及前足,特别是缺损较大时,选择游离皮瓣更为适宜。     

The distally based posterolateral supramalleolar neurofasciocutaneous island flap for coverage defects over the distal third of the leg and foot

A traditional-designed distally based sural flap centralized on the axis of the (medial) sural nerve and the lesser saphenous vein has been used widely for coverage of the distal third of the leg, ankle, malleoli, and foot. However, a variety of 5% to 47% of flap necrosis after the flap elevation and transposition were recorded in the literature. The unreliability of the distal part of the flap, especially when skin paddle located at the proximal third of the leg is at least partly due to their subfascial coursing of the median superficial sural artery and the medial sural nerve as well as the lesser saphenous vein. Based on the anatomic characteristics of the sural nerve and previous angiographic studies, a longitudinal chain-linked axial vascular network along with the sural nerve and the lateral sural nerve had been demonstrated on the posterolateral side of the leg from lateral retromalleolar gutter to the fibular head. A distally based posterolateral supramalleolar neurofasciocutaneous island flap centralized on this longitudinal neurovascular network was designed and used to reconstruct and cover the defects over the distal third of the leg, lateral malleolus, foot, and Achilles tendon. In this report we retrospectively review the clinical outcomes. This flap was used in 11 patients, including six young children aged 3 to 6 years. All flaps survived fully without complications except one flap which experienced postoperative infection which was controlled by dressing change and antibiotic application. Relevant surgical anatomy and detailed surgical techniques for elevation of the flap and its versatile usage are presented. Risks leading to flap necrosis, safe pedicle design, and manipulations etc. are discussed. In conclusion, this distally based posterolateral supramalleolar neurofasciocutaneous island flap is reliable and very useful for covering defects over the distal leg, ankle, heel, foot, and Achilles tendon, especially in young children.     

Increasing the success of reverse sural flap from proximal part of posterior calf for traumatic foot and ankle reconstruction: Patient selection and surgical refinement

In this report, we present our experience on the use of the reverse sural flap for traumatic foot and ankle reconstruction. The patient selection and surgical refinement are discussed. From 2007 to 2010, 11 consecutive patients underwent modified reverse sural flap at the Chang Gung Memorial Hospital. The defects were located at the ankle (three cases), foot (two cases), and heel (six cases). Particular attention was paid to precise patient selection and surgical refinements. Patient selection was based on the lower limb vascular status by palpable distal pedal pulses and ankle brachial index ranging from 0.9 to 1.2. Surgical techniques were refined as precisely locating the perforators of peroneal artery, placing the skin paddle in upper third of leg for a distal region coverage, designing a 7‐cm‐wide adipofascial pedicle with a 2 cm skin paddle on it, preserving the mesentery structure of sural nerve and concomitant artery with or without including gastrocnemius muscles cuff, no tunneling when inset this flap and supercharging with lesser saphenous vein whenever needed. All the flaps survived completely. Only one patient required immediate anastomosis of lesser saphenous vein to local vein around defect in order to relieve the venous congestion during operation. Patients felt diminished but adequate recovery of sense of touch and temperature at the flap. Following the precise patient selection and surgical refinements, the modified reverse sural flap seemed to be a reliable and effective local flap for reconstruction of the soft tissue defects on ankle and foot. © 2013 Wiley Periodicals, Inc. Microsurgery 33:342–349, 2013.     

Clinical and anatomical study of the distally based lesser saphenous veno-lateral sural neurocutaneous flap for lower extremity coverage

Background

The distally based sural flap has been widely and successfully used to reconstruct soft tissue defects of the distal third of the lower leg and foot. Sensory loss and venous congestion are possible complications of this treatment, but there has been limited research focused on improving the sensory loss and veneous congestion. This study aimed to determine the spatial relationship between the lesser saphenous vein and the cutaneous nerves, the venous anatomy in the lower leg, and the nerve distribution in the lateral dorsum of the foot, and we presented our clinical experience.

Materials and methods

Twenty freshly amputated lower limbs were dissected in the 2 h following amputation. The lesser saphenous vein, medial/lateral sural nerve, and sural nerve were identified. Based on the anatomical studies, an island flap supplied by the vascular axis of the lesser saphenous vein and the lateral sural nerve was designed for clinical reparative applications in 24 cases.

Results

We indicated the spatial relationship between the lesser saphenous vein and the cutaneous nerves and the venous anatomy in the lower leg. Among 24 flaps, 21 showed complete survival (87.5 %), while marginal flap necrosis occurred in two patients (8.33 %) and distal wound dehiscence in another (4.17 %). No symptomatic neuromas were observed. Their appearance and functioning were satisfactory, with filling maintained in the heel and lateral side of the foot.

Conclusion

The distally based lesser saphenous veno-lateral sural neurocutaneous flap provides effective coverage of variable-sized soft tissue defects on the lower third of the lower leg and foot, without sensory loss and venous congestion.     

Maximizing the reliability and safety of the distally based sural artery flap

Variations of the distally based sural artery flap have been used in the literature with varying success rates. This article stresses the axiality of this flap based on the sural nerve and the short saphenous vein. Forty distally based sural artery flaps were used for a variety of defects in the distal leg. In the proximal leg, the groove between the medial and lateral heads of the gastrocnemius muscle was explored to include the subfacial part of the medial sural nerve with the flap. The subfascial part of the nerve can consistently be included with the flap and gives off cutaneous supply to the tip of the flap to increase reliability of the distal part of the flap. The short saphenous vein should be harvested with an additional length to allow for supercharging or intermittent bleeding in the event of flap congestion. With this approach our success rate with this flap was 98%. To maximize the reliability of the distally based sural artery flap, the sural nerve and short saphenous vein must be included with the flap along its entire length.     

小隐静脉-腓肠外侧神经蒂皮瓣的临床应用

目的：探讨小隐静脉-腓肠外侧神经蒂皮瓣修复小腿创面的临床价值。方法：对既往小隐静脉-腓肠神经蒂皮瓣进行改进,设计以小隐静脉-腓肠外侧神经为蒂的皮瓣,临床应用修复下肢创面14例。结果：小隐静脉-腓肠外侧神经营养血管皮瓣全部成活,均获随访3个月～5年不等,肢体功能及外形均满意,足跟及足背外侧缘无感觉丧失区。结论：小隐静脉-腓肠外侧神经蒂皮瓣血运丰富、成活可靠,在修复小腿下段皮肤、软组织缺损的同时,有效地保留了足背外侧和足跟的感觉,提高了生活质量。     

荧光示踪法在体实验研究逆行岛状皮瓣静脉回流

目的用荧光示踪法研究逆行岛状皮瓣的静脉回流,探讨静脉回流的规律。方法40只新西兰大白兔,每只取耳静脉血各0．1ml,分离红细胞、FITC标记及检测。40只新西兰大白兔后肢建立隐动静脉逆行岛状筋膜皮瓣模型,每只将一侧后肢随机设定为实验组,对侧即为对照组,对照组制备相同皮瓣,但不注射示踪剂。实验组按照皮瓣制备的时间不同分成A、B、C、D4组,再根据注入示踪剂途径的不同,分为动脉和静脉2个亚组。取标记好的红细胞悬液5μl,在各组分别通过静脉和动脉注入。5s后取下皮瓣立即冷冻,分别自血管蒂的远段、中段和近段,采用连续的3张冰冻切片（5～7μm）,其中2张行HE染色和GENMED神经染色,另1张不染色直接压片。显微镜观察荧光分布。结果FITC标记的红细胞荧光强度均匀,可以用于示踪研究。冰冻切片显示试验组皮瓣蒂部均出现荧光,对照组未见荧光。A、B组荧光分布在动脉内膜、外膜和静脉壁;C组除动脉内膜、外膜和静脉壁有分布外,静脉腔偶有点片荧光;D组动脉内膜、外膜、静脉壁和静脉腔都有荧光分布。结论逆行岛状皮瓣早期静脉血通过动脉内膜、外膜和静脉壁的迷宫途径回流;后期通过动脉内膜、外膜和静脉壁的迷宫途径及经静脉腔的逆瓣膜途径回流。