改良动脉化游离静脉皮瓣临床应用研究

目的　 探索进一步提高动脉化静脉皮瓣成活的手术方式。 方法　在双干静脉之间“开沟”，切开脂肪层至真皮下血管网，将双干之间交通支断口结扎; 根据皮瓣大小，对动脉化静脉属支进行选择性结扎，控制皮瓣供血入量使之供血均匀。 结果　本组48个皮瓣，25例皮瓣术后红润。16例术后出现少量散在水泡，7例术后3~7 d出现淤血肿胀，48个皮瓣全部成活，优良率达到85%(41例)。 结论　经过双重改良设计切取的动脉化静脉皮瓣成活质量进一步提高，有临床推广应用意义。

Clinical application on improved arterial free venous flap

Objective　To explore the operative method of improving the survival of arterialized venous flap. Methods Ditching was made between the double dry veins, the adipose layer was cut into the subdermal vascular network, and the traffic branch fracture between the double dry veins was ligated. According to the size of the flap, selective ligation of the arterial vein branch was carried out to control the amount of blood supply from the skin flap to make the blood supply uniform. Results In the group, there were 48 flaps and 25 cases were ruddy after operation. A small amount of scattered blisters occurred in 16 cases, and congestion and swelling occurred in 7 cases 3~7 days after operation. All 48 flaps survived, the excellent and good rate was 85% (41 cases). Conclusions The survival quality of arterialized venous clap by the double modified design is further improved, which has the significance of clinical application.