• 1解放軍第89醫(yī)院全軍創(chuàng)傷骨科研究所（山東濰坊，261041）;;
  • 2 濰坊醫(yī)學(xué)院整形外科研究所;

目的研究股內(nèi)側(cè)肌肌皮穿支解剖學(xué)特征，設(shè)計(jì)游離股內(nèi)側(cè)肌穿支皮瓣，為臨床修復(fù)軟組織缺損提供一種新的皮瓣。 方法取6具自愿捐獻(xiàn)的新鮮成人下肢標(biāo)本，以氧化鉛混合紅色乳膠灌注，解剖股內(nèi)側(cè)肌肌皮穿支，并通過(guò)血管造影技術(shù)觀測(cè)股內(nèi)側(cè)肌肌皮穿支的起源、走行、分布情況。根據(jù)解剖研究，于2009年6月－2011年8月，臨床采用大小為14 cm × 6 cm～20 cm × 5 cm的股內(nèi)側(cè)肌穿支皮瓣修復(fù)4例足部皮膚軟組織缺損，缺損范圍8 cm × 6 cm～12 cm × 8 cm。 結(jié)果股動(dòng)脈恒定發(fā)出的股內(nèi)側(cè)肌動(dòng)脈在內(nèi)側(cè)肌內(nèi)下行至髕旁，終末支與旋股外側(cè)動(dòng)脈終末支吻合形成髕周血管網(wǎng)。沿途發(fā)出3～5支粗大肌皮穿支達(dá)深筋膜內(nèi)，并淺出至股內(nèi)側(cè)肌表面皮膚，構(gòu)成股內(nèi)側(cè)血管網(wǎng)。臨床應(yīng)用4例股內(nèi)側(cè)肌穿支皮瓣均成活，受區(qū)創(chuàng)面及供區(qū)切口均Ⅰ期愈合；患者均獲隨訪(fǎng)，隨訪(fǎng)時(shí)間6～12個(gè)月，皮瓣色澤、質(zhì)地良好，踝關(guān)節(jié)背伸、跖屈活動(dòng)范圍正常。 結(jié)論游離股內(nèi)側(cè)肌穿支皮瓣切取簡(jiǎn)便，皮瓣供區(qū)隱蔽，質(zhì)地優(yōu)良，是理想的皮瓣供區(qū)。

引用本文： 郭永強(qiáng),梁曉琴,王劍利,王成琪,郭德亮,王常德,崔磊. 游離股內(nèi)側(cè)肌穿支皮瓣的解剖研究與臨床應(yīng)用. 中國(guó)修復(fù)重建外科雜志, 2012, 26(9): 1091-1094. doi: 復(fù)制

1. 徐達(dá)傳, 張世民, 唐茂林, 等. 穿支皮瓣的發(fā)展與現(xiàn)狀. 中國(guó)修復(fù)重建外科雜志, 2011, 25(9): 1025-1029.
2. 吳學(xué)強(qiáng), 劉會(huì)仁, 劉德群. 股前外側(cè)皮瓣應(yīng)用研究的進(jìn)展. 中華顯微外科雜志, 2011, 34(1): 83-85.
3. Hanasono M, Skoracki RJ, Yu P. A prospective study of donor-site morbidity after anterolateral thigh fasciocutaneous and myocutaneous free flap harvest in 220 patients. Plast Reconstr Surg, 2010, 125(1): 209-214.
4. 楊曉東, 丁茂超, 梅勁, 等. 股前內(nèi)側(cè)穿支皮瓣的應(yīng)用解剖學(xué)研究. 中國(guó)臨床解剖學(xué)雜志, 2011, 29(6): 624-628.
5. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg, 1987, 40(2): 113-141.
6. Cormack GC, Lamberty BG. A classification of fascio-cutaneous flaps according to their patterns of vascularisation. Br J Plast Surg, 1984, 37 (1): 80-87.
7. Rozen WM, Grinsell D, Koshima I, et al. Dominance between angiosome and perforator territories: a new anatomical model for the design of perforator flaps. J Reconstr Microsurg, 2010, 26(8): 539-545.
8. Cotrufo S, Dabernig J, Russell D, et al. The vascular anatomy of the rat superficial epigastric flap by vascular corrosion casting and technical refinement for the study of choke vessels in cadaveric flap models. Ann Plast Surg, 2010, 64(1): 93-97.
9. Sinna R, Boloorchi A, Mahajan AL, et al. What should define a “perforator flap”? Plast Reconstr Surg, 2010, 126(6): 2258-2263.
10. Blondeel PN, Van Landuyt KH, Monstrey SJ, et al. The “Gent” consensus on perforator flap terminology: preliminary definitions. Plast Reconstr Surg, 2003, 112(5): 1378-1387.
11. 張世民, 唐茂林, 穆廣態(tài), 等. 穿支皮瓣及相關(guān)術(shù)語(yǔ)的專(zhuān)家共識(shí). 中國(guó)臨床解剖學(xué)雜志, 2010, 28(5): 475-477.
12. Pan WR, Taylor GI. The angiosomes of the thigh and buttock. Plast Reconstr Surg, 2009, 123(1): 236-249.
13. Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg, 1984, 37(2): 149-159.
14. Koshima I, Hosoda M, Inagawa K, et al. Free medial thigh perforator-based flaps: new definition of the pedicle vessels and versatile application. Ann Plast Surg, 1996, 37(5): 507-515.
15. Yu P, Selber J. Perforator patterns of the anteromedial thigh flap. Plast Reconstr Surg, 2011, 128(3): 151e-157e.
16. Xu ZF, Sun CF, Duan WY, et al. Clinical anatomical study and evaluation of the use of the free anteromedial thigh perforator flaps in reconstructions of the head and neck. Br J Oral Maxillofac Surg, 2011. [Epub ahead of print].
17. Hong JP, Kim EK, Kim H, et al. Alternative regional flaps when anterolateral thigh flap perforator is not feasible. J Hand Microsurg, 2010, 2(2): 51-57.
18. Kim JT, Kim CY, Kim YH. T-anastomosis in microsurgical free flapreconstruction: an overview of clinical applications. J Plast Reconstr Aesth Surg, 2008, 61(10): 1157-1163.
19. Koshima I, Fujitsu M, Ushio S, et al. Flow-through anterior thigh flaps with a short pedicle for reconstruction of lower leg and foot defects. Plast Reconstr Surg, 2005, 115(1): 155-162.
20. Hallock GG. The complete nomenclature for combined perforator flaps. Plast Reconstr Surg, 2011, 127(4): 1720-1729.
  1. 1. 徐達(dá)傳, 張世民, 唐茂林, 等. 穿支皮瓣的發(fā)展與現(xiàn)狀. 中國(guó)修復(fù)重建外科雜志, 2011, 25(9): 1025-1029.
  2. 2. 吳學(xué)強(qiáng), 劉會(huì)仁, 劉德群. 股前外側(cè)皮瓣應(yīng)用研究的進(jìn)展. 中華顯微外科雜志, 2011, 34(1): 83-85.
  3. 3. Hanasono M, Skoracki RJ, Yu P. A prospective study of donor-site morbidity after anterolateral thigh fasciocutaneous and myocutaneous free flap harvest in 220 patients. Plast Reconstr Surg, 2010, 125(1): 209-214.
  4. 4. 楊曉東, 丁茂超, 梅勁, 等. 股前內(nèi)側(cè)穿支皮瓣的應(yīng)用解剖學(xué)研究. 中國(guó)臨床解剖學(xué)雜志, 2011, 29(6): 624-628.
  5. 5. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg, 1987, 40(2): 113-141.
  6. 6. Cormack GC, Lamberty BG. A classification of fascio-cutaneous flaps according to their patterns of vascularisation. Br J Plast Surg, 1984, 37 (1): 80-87.
  7. 7. Rozen WM, Grinsell D, Koshima I, et al. Dominance between angiosome and perforator territories: a new anatomical model for the design of perforator flaps. J Reconstr Microsurg, 2010, 26(8): 539-545.
  8. 8. Cotrufo S, Dabernig J, Russell D, et al. The vascular anatomy of the rat superficial epigastric flap by vascular corrosion casting and technical refinement for the study of choke vessels in cadaveric flap models. Ann Plast Surg, 2010, 64(1): 93-97.
  9. 9. Sinna R, Boloorchi A, Mahajan AL, et al. What should define a “perforator flap”? Plast Reconstr Surg, 2010, 126(6): 2258-2263.
  10. 10. Blondeel PN, Van Landuyt KH, Monstrey SJ, et al. The “Gent” consensus on perforator flap terminology: preliminary definitions. Plast Reconstr Surg, 2003, 112(5): 1378-1387.
  11. 11. 張世民, 唐茂林, 穆廣態(tài), 等. 穿支皮瓣及相關(guān)術(shù)語(yǔ)的專(zhuān)家共識(shí). 中國(guó)臨床解剖學(xué)雜志, 2010, 28(5): 475-477.
  12. 12. Pan WR, Taylor GI. The angiosomes of the thigh and buttock. Plast Reconstr Surg, 2009, 123(1): 236-249.
  13. 13. Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg, 1984, 37(2): 149-159.
  14. 14. Koshima I, Hosoda M, Inagawa K, et al. Free medial thigh perforator-based flaps: new definition of the pedicle vessels and versatile application. Ann Plast Surg, 1996, 37(5): 507-515.
  15. 15. Yu P, Selber J. Perforator patterns of the anteromedial thigh flap. Plast Reconstr Surg, 2011, 128(3): 151e-157e.
  16. 16. Xu ZF, Sun CF, Duan WY, et al. Clinical anatomical study and evaluation of the use of the free anteromedial thigh perforator flaps in reconstructions of the head and neck. Br J Oral Maxillofac Surg, 2011. [Epub ahead of print].
  17. 17. Hong JP, Kim EK, Kim H, et al. Alternative regional flaps when anterolateral thigh flap perforator is not feasible. J Hand Microsurg, 2010, 2(2): 51-57.
  18. 18. Kim JT, Kim CY, Kim YH. T-anastomosis in microsurgical free flapreconstruction: an overview of clinical applications. J Plast Reconstr Aesth Surg, 2008, 61(10): 1157-1163.
  19. 19. Koshima I, Fujitsu M, Ushio S, et al. Flow-through anterior thigh flaps with a short pedicle for reconstruction of lower leg and foot defects. Plast Reconstr Surg, 2005, 115(1): 155-162.
  20. 20. Hallock GG. The complete nomenclature for combined perforator flaps. Plast Reconstr Surg, 2011, 127(4): 1720-1729.