摘要
目的总结旋髂浅动脉穿支皮瓣游离移植修复四肢软组织缺损的临床应用经验及皮瓣血管蒂的解剖变异情况。方法回顾性分析2015年12月-2018年11月采取旋髂浅动脉穿支皮瓣游离移植修复的44例四肢软组织缺损患者资料,并进行临床和解剖学总结。结果44例中40例全部成活,1例坏死,3例部分成活。随访3~12个月,部分坏死的3例均未做特殊处理,经换药创面愈合;完全坏死的1例再次行皮瓣修复。旋髂浅动脉的解剖:39例旋髂浅动脉均起自股动脉,3例与旋髂深动脉共干,2例起自股深动脉;旋髂浅动脉均分支为旋髂浅的深支和浅支,其中深、浅支共干的39例,深、浅支不共干的5例,分别由股动脉发出;44例均存在旋髂浅静脉,42例存在伴行静脉;旋髂浅动脉起始部位的口径最大1.6 mm,最小0.5 mm,平均1.0 mm,其伴行静脉口径最大2.0 mm,最小0.5 mm,平均1.1 mm,旋髂浅静脉口径最大1.8 mm,最小1.0 mm,平均1.3 mm。旋髂浅动脉深支与股外侧皮神经的关系:血管位于神经浅层的35例,血管位于神经束之间的5例,血管位于神经深层的4例。结论旋髂浅动脉穿支皮瓣游离移植修复四肢软组织缺损是可行的,但皮瓣血管蒂存在一定的解剖变异。
Objective To investigate the clinical application experience and the anatomical variation of the vascular pedicle of the superficial iliac circumflex artery perforator flap for repairing soft tissue defects of the extremities.Methods The clinicopathological data of 44 patients with soft tissue defects of the extremities who were repaired by free grafting of the superficial iliac perforator flap from December 2015 to November 2018 were retrospectively analyzed.Results Among 44 patients,40 perforator skin flap survived,1 case was completely necrotic and 3 cases were partially necrotic.The follow-up period lasted for 3 months to 1 year.These 3 patients with partial necrosis achieved wound healing without receiving special treatment,however,one case with complete necrosis underwent flap repair again.Anatomy of the superficial circumflex iliac artery:all 39 cases of the superficial circumflex iliac artery originated from the femoral artery,3 cases were co-stem with the deep circumflex iliac artery,and 2 cases originated from the deep femoral artery.All the branches of the superficial circumflex iliac arteries were the deep and shallow branches of the superficial circumflex iliac arteries.In 39 cases,the deep and shallow branches had a common trunk,and in 5 cases,the deep and shallow branches did not have a common trunk.The superficial circumflex iliac vein was found in all 44 patients,and the accompanying vein was found in 42 patients.The maximum,minimum and average diameter of the superficial circumflex iliac artery was 1.6 mm,0.5 mm and 1.0 mm,respectively.The maximum,minimum and average diameter of the accompanied vein was 2.0 mm,0.5 mm and 1.1 mm on average,respectively.The maximum,minimum and average diameter of the superficial circumflex iliac vein was 1.8 mm,1.0 mm and 1.3 mm on average,respectively.The relationship between the deep branch of the superficial circumflex iliac artery and the nervus cutaneus femoris lateralis:the blood vessels were located in the superficial nerve layer in 35 cases,the blood vesse
作者
李培
郭亮
林金贵
林世备
吴学军
LI Pei;GUO Liang;LIN Jingui(Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian,350122,China)
出处
《实用手外科杂志》
2021年第2期148-151,共4页
Journal of Practical Hand Surgery
关键词
旋髂浅动脉
皮瓣
四肢
缺损
修复
Superficial circumflex iliac artery
Skin flap
Limbs
Defect
Repair
