以上肢浅表皮神经伴行血管为蒂的岛状皮瓣的解剖学研究

对上肢浅表皮神经及其伴行血管与皮肤血供的关系进行显微解剖学研究后,设计出以上肢浅表皮神经伴行血管为蒂的岛状皮瓣。方法:新鲜成人上肢标本22侧,从肱动脉灌注红色乳胶后,对上肢浅表皮神经及伴行血管进行显微解剖。结果:(1)所有上肢皮神经都有来源于上肢知名血管的营养血管伴行。(2)与上肢浅表皮神经的伴行血管既营养神经,同时沿途又发出分支营养皮肤。(3)皮神经的伴行血管穿出深筋膜的部位有一定的规律性。结论;(1)上肢浅表皮神经的伴行血管为蒂的岛状皮瓣血供可靠,静脉回流充分,并可形成逆行蒂或顺行蒂岛状皮瓣。(2)以第2、3掌背皮神经伴行血管为蒂的岛状皮瓣,神经行走变异较多,伴行血管不稳定,临床选用时须慎重考虑。

An anatomic study of neurocutaneous concomitant vessel pedicled island flap of the upper extremities

Objective:To design island flaps pedicled on neurocutaneous concomitant vessels in the upper extremity on the bases of microsurgical anatomy of the cutaneous nerves,their concomitant vessels and the skin supplied by them. Methods: 22 upper extremities of fresh adult cadavers were involved in the series. Red latex was perfused into the humeral arteries of the samples to facilitate the microsurgical anatomy of the cutaneous nerves and their concomitant vessels. Results:(1)All the cutaneous nerves have concomitant vessels, which originate from septocutaneous branches, muscular perforators and direct cutaneous branches of known vessels in the extremities. (2)The concomitant vessels of the nerves not only supply the nerves, but give out minute branches to the skin along their course. (3)The penetrating point where the concomitant vessels perforate deep fascia has a regular pattern. Conclusions: (1) The island flap based on neurocutaneous concomitant vessels has liable blood supply, enough venous drainage and can be designed retrogradely and anterogradely. (2)The island flap based on the second or third dorsal metacarpal cutaneous nerve concomitant vessels should be used with caution in that the concomitant vessels are not constant and the courses variable.