Stadler F, Brenner E, Todoroff B, Papp C
Institute for Anatomy, University of Innsbruck, 6010 Innsbruck, Austria.
Anat Rec. 1999 Aug 1;255(4):374-9. doi: 10.1002/(SICI)1097-0185(19990801)255:4<374::AID-AR2>3.0.CO;2-2.
Difficulty of soft tissue defects of the lower leg demands the development of new methods to treat such defects. The aim of this study is the examination of perforators and the various ways of blood supply to the skin in the lower leg. Provided with certain regularity, we would be able to cure soft-tissue defects also in the difficult zone of the distal segment and on the dorsum of the foot not harming vessels and not affecting mobility of muscles. Subcutaneous island-flaps supplied by perforating vessels could replace free flaps. By saving the crural fascia of 10 lower legs we flayed layers of skin and fat, marked the perforating vessels with pins, and photographed and documented them. Specimens were divided into a proximal, an intermediate and a distal segment, each of them subdivided into a medial, lateral and dorsal section. The perforators, which can be classified as septocutaneous and musculocutaneous vessels, followed a reproducible pattern all over the lower leg. All vessels were sufficient in number as well as in size. Additionally these perforators can easily be identified by colour-coded sonography. The knowledge that perforators in the lower leg occur regularly enables the development of a new operative approach in therapy of soft-tissue defects in this region with the advantage, that the vessels used can be selected preoperatively.
小腿软组织缺损的治疗难度促使人们开发新的方法来治疗此类缺损。本研究的目的是检查穿支血管以及小腿皮肤的各种血液供应方式。如果具备一定的规律性，我们将能够治愈小腿远端和足背困难区域的软组织缺损，而不会损伤血管且不影响肌肉活动。由穿支血管供血的皮下岛状皮瓣可以替代游离皮瓣。我们通过保留10条小腿的小腿筋膜，剥除皮肤和脂肪层，用大头针标记穿支血管，并对其进行拍照和记录。标本分为近端、中间段和远端段，每段又细分为内侧、外侧和背侧部分。穿支血管可分为肌间隔皮血管和肌皮血管，在小腿各处呈现出可重复的模式。所有血管在数量和大小上都足够。此外，这些穿支血管可以通过彩色编码超声很容易地识别出来。小腿穿支血管有规律地出现这一认识，使得在该区域软组织缺损的治疗中能够开发一种新的手术方法，其优点是所使用的血管可以在术前进行选择。
