• 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)學院整形外科研究所;

目的研究股內側肌肌皮穿支解剖學特征，設計游離股內側肌穿支皮瓣，為臨床修復軟組織缺損提供一種新的皮瓣。 方法取6具自愿捐獻的新鮮成人下肢標本，以氧化鉛混合紅色乳膠灌注，解剖股內側肌肌皮穿支，并通過血管造影技術觀測股內側肌肌皮穿支的起源、走行、分布情況。根據解剖研究，于2009年6月－2011年8月，臨床采用大小為14 cm × 6 cm～20 cm × 5 cm的股內側肌穿支皮瓣修復4例足部皮膚軟組織缺損，缺損范圍8 cm × 6 cm～12 cm × 8 cm。 結果股動脈恒定發(fā)出的股內側肌動脈在內側肌內下行至髕旁，終末支與旋股外側動脈終末支吻合形成髕周血管網。沿途發(fā)出3～5支粗大肌皮穿支達深筋膜內，并淺出至股內側肌表面皮膚，構成股內側血管網。臨床應用4例股內側肌穿支皮瓣均成活，受區(qū)創(chuàng)面及供區(qū)切口均Ⅰ期愈合；患者均獲隨訪，隨訪時間6～12個月，皮瓣色澤、質地良好，踝關節(jié)背伸、跖屈活動范圍正常。 結論游離股內側肌穿支皮瓣切取簡便，皮瓣供區(qū)隱蔽，質地優(yōu)良，是理想的皮瓣供區(qū)。

引用本文： 郭永強,梁曉琴,王劍利,王成琪,郭德亮,王常德,崔磊. 游離股內側肌穿支皮瓣的解剖研究與臨床應用. 中國修復重建外科雜志, 2012, 26(9): 1091-1094. doi: 復制

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1. 徐達傳, 張世民, 唐茂林, 等. 穿支皮瓣的發(fā)展與現(xiàn)狀. 中國修復重建外科雜志, 2011, 25(9): 1025-1029.
2. 吳學強, 劉會仁, 劉德群. 股前外側皮瓣應用研究的進展. 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. 股前內側穿支皮瓣的應用解剖學研究. 中國臨床解剖學雜志, 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. 穿支皮瓣及相關術語的專家共識. 中國臨床解剖學雜志, 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. 徐達傳, 張世民, 唐茂林, 等. 穿支皮瓣的發(fā)展與現(xiàn)狀. 中國修復重建外科雜志, 2011, 25(9): 1025-1029.
  2. 2. 吳學強, 劉會仁, 劉德群. 股前外側皮瓣應用研究的進展. 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. 股前內側穿支皮瓣的應用解剖學研究. 中國臨床解剖學雜志, 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. 穿支皮瓣及相關術語的專家共識. 中國臨床解剖學雜志, 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.