股深动脉穿支皮瓣应用于乳房再造的解剖学研究
The anatomical study for the application of profunda artery perforator flap in breast reconstruction
目的 为股深动脉穿支皮瓣应用于乳房再造提供解剖学依据。 方法 5例10侧成人新鲜下肢尸体标本进行乳胶或氧化铅动脉灌注，解剖观察后区域血管的形态及分布，测量股深动脉穿动脉穿支血管数量、管径、血管蒂长度及伴行静脉管径。在此基础上进行了股后区穿支皮瓣切取的手术模拟。 结果 股深动脉第1穿动脉发出4~9支穿支供应股后区皮肤，以肌皮穿支为主，偶可见肌间隔穿支；降支优势较多，优势穿支多发自股后内侧。血管蒂长为(10.6±2.6)cm，其外径为(2.2±1.0)cm，伴行静脉外径分别为(1.8±0.8)mm与(2.1±1.8)mm。 结论 股深动脉穿支皮瓣血供存在个体差异，尤以第1穿动脉对其影响较大，有待进一步研究确保皮瓣切取的安全性与精确性。
Objective To provide anatomic basis for the application of profunda artery perforator flap (PAP) in breast reconstruction. Methods Ten fresh human cadaveric thighs underwent a intraarterial injection of a lead oxide or latex preparation and dissected. The pattern of vascular distribution in the posterior thigh region was observed, and data relevant (the number of perforators, diameters of the arteries and veins accompanying, pedicle length) was measured. Results were reported as Mean±SD. Based on the anatomical basis above, Surgical simulation was proceeded. Results The first perforating artery of the profunda femoris artery gave rise to 4 to 9 cutaneous perforators (most myocutaneous ), and most of the dominant perforators which were located in the posteromedial thigh descended from the descending branch of the first perforating artery. The pedicle length was (10.6±2.6) cm, the average external diameter was (2.2±1.0) cm, and the external diameter of concomitant veins were (1.8±0.8)mm and (2.1±1.8)mm. Conclusions Regardless of the vascular variety of PAP flap, the first perforating artery of the profunda femoris artery plays an important role on its blood supply. However, more research need to be conducted to guarantee the safety and accuracy of procedure.
Posterior thigh / PAP / The first perforating artery / Breast reconstruction
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