轴型真皮下血管网皮瓣的应用解剖

目的　为临床应用轴型真皮下血管网皮瓣 (ASVNF)提供解剖学依据。方法　对 12侧下肢标本进行了解剖学观察。重点解剖观察股前外侧ASVNF和隐血管ASVNF的轴心血管在浅筋膜层的走行、分支、真皮下血管网 (SVN)的构筑和皮瓣超薄范围等情况。结果　肌皮穿支穿出深筋膜层后向周围不同方向发出三种分支 ,其中SVN分支斜穿较少浅筋膜后很快进入真皮下层形成吻合稠密的SVN ,制备股前外侧ASVNF应采用“圆形”超薄法。直接皮肤血管在浅筋膜层纵行途中主要向两侧及浅面发出分支 ,制备隐血管ASVNF应采用“U形”超薄法。SVN分支在真皮下层反复分支形成“血管树”或“蜘蛛痣”状血管网 ,且血管网之间稠密吻合。结论　不同血供类型ASVNF的超薄方法应不同。

The applied anatomy of axial subdermal vascular network skin flaps

Objective To supply the applied anatomy for using axial subdermal vascular network flap(ASVNF).Methods 12 lower limbs of adult cadavers were anatomically observed.The axial vascular and branches,the subdermal vascular network architecture and thin methods of the anterolateral formoral ASVNF and the saphenous ASVNF were observed.Results The musculocutanous perforator gave 3 kinds of branches to surrounding after perforated the deep fascia,the SVN banches anastomosized densely in subdermal and to architecture SVN after perforated obliquel a little superfical fascia.The circle cutting methods should be used for making the anterolateral formoral ASVNF.The directive skin vessel gave branches to two sides and superficial in through fascia paralleling the axis.The “U” shape cutting methods should be used for making the saphenous ASVNF.The “tree” of vascular network and the “spider” vascular network were made by the SVN branches anastomosized densely in subdermal.Conclusions The thin methods are different in different types of skin blood vessels of ASVNF.