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桡侧前臂皮瓣在筋膜上和筋膜下采集的比较

时间:2009年02月20日13:58 来源:好医生网站

桡侧前臂皮瓣在筋膜上和筋膜下采集的比较:一个解剖研究

 

Supra fascial Compared With Subfascial Harvest of the Radial Forearm Flap: An Anatomic Study
桡侧前臂皮瓣在筋膜上和筋膜下采集的比较:一个解剖研究

 
Mark Schaverien MDa and Michel Saint-Cyr MD , a,
aDepartment of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Received 14 June 2007; accepted 14 September 2007. Available online 5 February 2008.


Purpose目的
Inclusion of the deep fascia within the radial forearm flap is conventionally thought to be essential for flap viability. Angiography and dissection studies were used in this study to elucidate the role of the deep fascia in perfusion of the radial forearm flap.
桡侧前臂皮瓣的深筋膜内容物被常规地认为对皮瓣的存活是必不可少的。在此研究中,血管造影术和解剖研究被用来阐明深筋膜对桡侧前臂皮瓣的血液供应所起的作用。

 
Methods方法
Twenty-four radial forearm flaps were harvested from 12 fresh cadavers. Ten paired suprafascial and subfascial flaps were harvested, the radial arteries were cannulated, and methylene blue dye was injected into the radial artery followed by a barium sulfate/gelatin mixture. The flaps were digitally radiographed, and the vascular territory was measured using software. The cutaneous dye staining patterns for paired flaps were recorded photographically. Computed tomography scans were performed for 3 paired flaps to evaluate the vascular pattern within the flap. Two pairs of forearms were subjected to intravascular injection with colored latex through the brachial artery prior to flap harvest, and microdissection of the flap and fascia was performed.
12具新鲜尸体上取下24个桡侧前臂皮瓣。10对取下的筋膜上和筋膜下皮瓣,桡动脉被插入导管,蓝色亚甲基染料和硫酸钡混合后被注入血管内,对皮瓣行数字化摄影,用软件来测量血管分布区。这些成对皮瓣的皮肤表面上染料染色模式通过摄影被保留了下来,CT断层扫描用在其中3对皮瓣上,用来评估皮瓣上的血管模式。2对前臂在取皮瓣前,已预先通过肱动脉注入有色橡胶,且皮瓣和筋膜的显微解剖已完成。

 
Results结果
No significant difference was found in the vascular territory measured for the flap when harvested using the subfascial or the suprafascial technique. Flap dissection studies confirmed that this is because of the poorly developed subfascial plexus in the forearm, with preservation of the deep fascia not contributing to the mechanism of flap perfusion.
用筋膜上和筋膜下技术制取的皮瓣,测量其血管分布区没有显著的差别,皮瓣的解剖研究表明,因为前臂的筋膜下网状组织发育不良,在深筋膜的保护下,并不能对皮瓣的灌注起作用。


Conclusions结论
Inclusion of the deep fascia during flap harvest does not contribute to the perfusion of the radial forearm flap and therefore the deep fascia does not need to be included to maintain flap vascularity.
皮瓣制取过程中深筋膜内容物对桡侧前臂皮瓣的灌注不起作用,因此深筋膜对维持皮瓣的血管供应是不必要的。

 
Key words: Harvest; radial forearm flap; subfascial; suprafascial; vascular anatomy
关键词:采集,桡侧前臂皮瓣,筋膜下,筋膜上,脉管解剖学

 

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