腓动脉穿支皮瓣的解剖与临床应用

目的:通过解剖学研究,分析腓动脉穿支特点,评价腓动脉穿支游离皮瓣临床应用的安全性和可行性.方法:10%甲醛固定成人尸体标本10具共20侧小腿,解剖观察腓动脉穿支数,测量各穿支穿出点与腓骨小头间距离、各穿支外径及血管蒂长度,并总结其规律性;采用游离腓动脉穿支皮瓣或筋膜瓣移植修复手足皮肤缺损43例.结果:10具20侧标本腓动脉穿支数平均为(6.35±1.15)支;在腓骨小头下方(9.8±0.93)cm,(13.4±0.90)cm,(17.2±1.13cm,(21.3±0.77)cm 4处,腓动脉穿支出现较恒定;上述四个位置穿支外径分别为(1.33±0.39)mm,(1.30±0.46)mm,(1.17±0.30)mm,(1.22±0.23)mm;血管蒂长分别为(5.87±0.73)cm,(5.83±1.73)cm,(5.44±1.09)cm,(5.10±1.93)cm.临床应用43例中,皮瓣完全成活42例,部分坏死1例.结论:腓动脉各穿支出现基本恒定,其中小腿中1/3段的穿支血管管径较粗,血管蒂较长,是穿支皮瓣切取的合适部位.腓动脉穿支皮瓣游离移植,是临床修复手足皮肤缺损的理想术式.

An Anatomic and Clinical Study on the Perforator Flap of Peroneal Artery

Objective：To explore the anatomic characteristics of the peroneal perforator branches as well as its clinical safety and feasibility as vascularized flap transfer. Methods：The muscular-cutaneous bran- ches of the peroneal artery were disected in 10 cadaver specimen with 20 lower limbs, the number of peferators, distance to fibular head, diameter and the length of the vascular pedicals were measured and analyzed. 43 cases with the skin defects were performed vascularized transfer. Results ： Perforators were observed most at （9.8 ± 0. 93） cm, （13.4 ±0.90）cm, （17.2 ± 1. 13 ）cm, （21.3 ± 0.77 ）cm beneath the fibular head with the artery branch diameter （ 1.33 ± 0.39 ） mm, （ 1.30 ±0.46） mm, （ 1.17 ± 0.30 ） ram, （ 1.22± 0.23 ） mm , while the pediclc length at （5.87 ± O. 73 ） era, （5.83 ± 1.73 ） cm, （ 5.44 ± 1.09 ） cm, （3.5± 1.93 ） cm respectively. 42/ 43 free flaps survived, 1 case of dermal petal necrosis. Conclusions： There are consistent perferators in lateral calf, while those in the middle 1/3 are especially larger with relatively longer vascular pedieles which are appropriate for vaseularized transfer.