肘前穿支皮瓣的解剖与临床应用

目的 探讨肘前穿支皮瓣解剖、供区的设计和临床应用. 方法通过10侧尸体解剖,应用红、黄、蓝三色乳胶灌注研究皮瓣的血管、神经的起源、走行、分支、外径、分布及其吻合情况,一侧新鲜尸体标本行墨汁注射测量皮瓣面积,根据肘前穿支皮瓣血供来源及其与前臂筋膜皮肤血供的相互关系,设计肘前穿支皮瓣.利用近端蒂肘前穿支皮瓣转位修复肘部各方位的皮肤软组织缺损、远端蒂肘前穿支皮瓣修复前臂中下段掌背侧皮肤软组织缺损共7例. 结果术后皮瓣完全成活,创面Ⅰ期愈合.经3～15个月随访,皮瓣质地优良,色泽接近正常,外形美观.结论 肘前穿支皮瓣解剖位置恒定,血液供应良好,手术方法简单、安全,为修复肘部、前臂中下段皮肤软组织的缺损提供一种新的术式,可供临床选择.

Dissection and clinical application of antecubital perforating branches flap

Objective To investigate the dissection of antecubital perforator flap and the design of donor site and its clinical application. Methods The origin, trending, branches, outer diameter, distribution and anastomosis of blood vessels and nerves were studied by perfusing red, yellow and blue emulsion into 10 cadaver specimens. The area of the antecubital perforating flap was measured after injecting ink to one fresh cadaver specimen. Then, antecubital perforator flap was designed according to the source of blood supply of antecubital perforating flap and its relationship with the blood supply of forearm fascia. The soft tissue defect of elbow skin was repaired by proximal pedicle of antecubital perforating flap, and the palmar and dorsal defect in middle and lower segment of the forearm were repaired by distal pedicle of antecubitai perforating flap in seven patients. Results All the flaps were survived, with wound healing by first intention. All patients were followed up for 3-15 months, with fine appearance and good texture and color of the flaps. Conclusions Antecubital perforator flap has the advantages of constant anatomical location, perfect blood supply, simple and safe application during operation, and it is excellent in repairing the skin defect of the elbow and middle or lower segment of the forearm.