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山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (11): 103-.

• 临床医学 • 上一篇    下一篇

股后外侧穿支皮瓣的解剖特征与游离移植应用

梁晓琴1,郭永强2,王剑利2,霍然1   

  1. 1.山东大学附属省立医院烧伤整形科, 济南 250021;
    2.中国人民解放军第89医院创伤骨科研究所,  山东 潍坊 261021
  • 收稿日期:2012-07-08 出版日期:2012-11-10 发布日期:2012-11-10
  • 通讯作者: 霍然(1967- ),男,教授,博士生导师,主要从事烧伤整形及血管瘤的研究。 E-mail:huoran@medmail.com.cn
  • 作者简介:梁晓琴(1974- ),女,博士研究生,副教授,主要从事整形与修复重建的研究。 E-mail:liangxq2002@163.com

Anatomical features and free transplantation of the
posterolateral thigh perforator flap

LIANG Xiao-qin1, GUO Yong-qiang2, WANG Jian-li2, HUO Ran1   

  1. 1. Department of Burn and Plastic Surgery, Provincial Hospital Affiliated to Shandong Univeristy, Jinan 250021, China;
    2. Department of Orthopaedics,89th Hospital of PLA, Weifang 261021, Shandong, China
  • Received:2012-07-08 Online:2012-11-10 Published:2012-11-10

摘要:

目的   研究股后外侧皮穿支解剖学特征,设计应用游离股后外侧穿支皮瓣修复四肢软组织缺损。方法   选取成人下肢标本,以氧化铅混合红色乳胶灌注,解剖观测股后外侧区外径>0.5mm的穿支,观测股后外侧皮穿支的起源、走行、分布及其吻合情况;通过血管造影技术显示股后外侧体被皮肤血管分布特点。临床切取游离股后外侧肌穿支皮瓣修复四肢皮肤缺损6例,缺损面积10cm×5cm~16cm×7cm。结果   解剖发现股深动脉来源的1~3穿动脉发出恒定的股后外侧皮穿支,穿支血管直径(1.2±0.3)mm,游离血管蒂长度范围6.1~14.3cm,穿支纵向分布于股后外侧区坐骨结节与股骨外上髁连线上,并沿此轴线构成股后外侧血管网。临床应用6例游离股后外侧穿支皮瓣修复四肢软组织,皮瓣一期愈合,供区直接缝合,随访6~12个月,皮瓣外观及功能满意,质地良好。结论   游离股后外侧穿支皮瓣解剖恒定,切取方法简单,皮瓣质地优良,可用于四肢部位软组织缺损显微外科修复。

关键词: 穿支皮瓣;股深动脉;股后外侧区;组织缺损;解剖

Abstract:

Objective    To investigate the anatomic features of the posterolateral thigh perforator and the clinical application of the free posterolateral thigh perforator flaps for repairing the soft tissue defect in extremities. Methods   Fresh lower limb specimens underwent an intraarterial injection of a lead oxide and red gelatin preparation. The integument of the thigh was dissected, and perforators of 0.5mm or more in the posterolateral thigh region were identified. Their origin, course, distributon, and  anastomosis were observed. The distribution features of skin and vessels in the posterolateral thigh region were documented by angiography and photography. Free posterolateral thigh perforator flaps were used in 6 patients with the soft tissue defects. The size of the defects ranged from 10cm×5cm to 16cm×7cm. Results   The perforating arteries from profunda femoris created cutaneous perforators in the posterolateral thigh. Their average external diameter was about 1.2±0.3mm. The average pedical length from the deep fascia was 6.1~14.3cm. Cutaneous perforators could be found on a line extending from the ischium to the lateral femoral condyle and constructed a vascular net aline the axis. All flaps survived after surgery with the donor sites healed by first intention. After following up for 6~12 months, the appearance and function of the flaps were all satisfactory with excellent texture. Conclusion   The free posterolateral thigh perforator flap is easy to perform with constant location and excellent texture. It can be a useful alternative to repair the soft tissue defect of the extremities.

Key words: Perforator flap; Profunda femoris artery; Posterolateral thigh region; Soft tissue defect; Anatomy

中图分类号: 

  • R622.1
[1] 王灵平1,张春莲2,胡顺鹏1,李文波1,3,曹成波1. 脱细胞真皮基质的制备与性能分析[J]. 山东大学学报(医学版), 2011, 49(9): 41-44.
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