腹壁浅动脉皮瓣的应用解剖及其在头颈部修复中的意义
Applied anatomy of the superficial inferior epigastric artery flap and its clinical significance in repairing head and neck defect
目的 探讨腹壁浅动脉皮瓣的解剖学基础及其在头颈修复中的意义。 方法 在10例动脉内灌注红色乳胶的成人标本上，解剖观察并测量腹壁浅动、静脉的起源、走行、分支、分布、外径、蒂长及与周围血管的毗邻关系。 结果 腹壁浅动脉的出现率为90%（18侧），管径为(1.48±0.44) mm（0.85~2.43 mm）, 蒂长为(4.8±1.18) cm (2.56~7.02 mm)，腹壁浅静脉恒定，管径为：(2.33±0.71) mm (1.46~4.05 mm)，蒂长为：(5.45±1.2) cm（4.03~8.42 cm），当腹壁浅动脉缺如或管径细小、位置靠内侧时，外侧旋髂浅动脉上升支代偿性增粗。 结论 腹壁浅动脉皮瓣血供可靠，面积充足，供区损伤小，可选择性的应用于头颈部的多种软组织缺损修复。
Objective To study anatomic features of the superficial inferior epigastric artery(SIEA) flap and explore its clinical application in the repair of head and neck defects. Methods The origin, course, branch, distribution, diameter, pedicle length and neighbours of superficial inferior epigastric artery and vein were dissected and measured in 10 adult corpses perfused with red latex through artery system. Results In our series of 20 cadaveric dissections, the SIEA was identified in 18(90%) and the SIEV in 20(100%). The external diameter of SIEA was 1.48±0.44mm(0.85~2.43）, The length of SIEA was 4.8±1.18 cm (2.56~7.02), averagely. The external diameter of SIEV ranged from 1.46 to 4.05mm, with the average value of 2.33±0.71mm. The length of SIEV ranged from 4.03 to 8.42cm, with the average value of 5.45±1.2cm. For those with absence or hypogenesis of SIEA, the longer and larger ascending branches of the superficial circumflex iliac artery system could be identified. Conclusions Considering its reliable blood supply, sufficient transfer area, and the slight donor site damage, the superficial inferior epigastric artery flap can be applied to reconstruct head and neck defects.
Superficial inferior epigastric artery (SIEA) / Surgery flap / Applied anatomy / Repair of head and neck defect
[1] 余光岩, 高 岩, 孙勇刚.口腔颌面部肿瘤
[M].北京:人民卫生出版社,2002：59-80.
[2] Wu LC, Bajaj A, Chang DW, et al .Comparison of donor-site morbidity of SIEA, DIEP, and muscle-sparing TRAM flaps for breast reconstruction
[J]. Plast Reconstr Surg, 2008 ,122 (3):702-709.
[3] Nasir S, Aydin MA. Reconstruction of soft tissue defect of lower extremity with free SCIA/SIEA flap
[J]. Ann Plast Surg, 2008 ,61(6):622-626.
[4] Woodworth BA, Gillespie MB, Day T, et al. Muscle-sparing abdominal free flaps in head and neck reconstruction
[J].Head Neak, 2006, 29 (8) : 802-807.
[5] Nasr S, Aydn MA. Versatility of free SCIA/SIEA flaps in head and neck defects
[J]. Ann Plast Surg, 2010 ,65(1):32-37.
[6] Fathi M, Hatamipour E, Fathi HR, et al.The anatomy of superficial inferior epigastric artery flap
[J]. Acta Cir Bras , 2008 ,23 (5) : 429-434.
[7] Fukaya E, Kuwatsuru R, Iimura H.Imaging of the superficial inferior epigastric vascular anatomy and preoperative planning for the SIEA flap using MDCTA
[J]. J Plast Reconstr Aesthet Surg, 2011, 64(1):63-68. Epub 2010 Apr 14
[8] Koshima I. Short pedicle superficial inferior epigastric artery adiposal flap:new anatomical findings and the use of this flap for reconstruction of facial contour
[J]. Plast Reconstr Surg，2005 , 116 (4): 1091 -1097.
[9] Aydin MA, Nasir S. Free SCIA/SIEA skin flap: a dual blood supply approach to groin region
[J]. Microsurgery, 2007, 27 (7) :617-622.
[10] 陈尔瑜,何光箎,程耕历等.腹股沟区皮瓣的血管 二.腹壁浅动脉和静脉的巨微解剖
[J].解剖学报,1982,13（2）:113-119.
[11] Wolfram D,Schoeller T,Hussl H,et al.The superficical inferior epigastric artery (SIEA) flap indication for breast reconstruction
[J]. Ann Plast Surg, 2006, 57(6):593-596.
[12]Nasir S, Aydin MA. Wide combined thin free SCIA/SIEA flap
[J].Ann Plast Surg, 2008, 61 (6) : 627-631.
[13]张志愿,郑家伟.口腔颌面部游离组织移植时受区血管的选择与吻合技术
[J].口腔颌面外科杂志,1999, 9 (2 ):155-160.
[14]Arnez ZM, Khan U, Pogorelec D, et al. Breast reconstruction using the free superficial inferior epigastric artery (SIEA) flap
[J]. Br J Plast Surg, 1999 ,52 (5) :351-354.
[15]Bianchi B, Ferrri A, Ferrari S, et al. Superficial inferior epigastric artery adiposal flap for facialc ontour reconstruction:Report of two cases
[J]. J Craniomaxillofac Surg, 2009, 37 (5) :249-252.
[16]Nasir S, Aydin MA, Altunta? S , et al. Soft tissue augmentation for restoration of facial contour deformities using the free SCIA/SIEA flap
[J].Microsurgery, 2008, 28 (5): 333-338.
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