Lykoudis Efstathios G, Spyropoulou Georgia-Alexandra Ch, Vlastou Catherine C
Department of Plastic Surgery and Burns, Ioannina University School of Medicine, University Campus, 45110 Ioannina, Greece.
Br J Plast Surg. 2005 Dec;58(8):1090-4. doi: 10.1016/j.bjps.2005.01.026. Epub 2005 May 31.
Another perforator flap, the gracilis perforator flap, has recently been added to the armamentarium of reconstructive surgeons. A detailed study of the anatomy of this flap was undertaken in this study. Forty-seven dissections were performed in cadavers and clinical cases of gracilis muscle harvesting for various reconstructive reasons. According to our findings, at least one musculocutaneous perforator of large calibre was found in the majority of the dissections performed (87%), emanating from the proximal third of gracilis. All the perforators were located within a radius of 7 cm from the point of entrance of the gracilis main vascular pedicle. In their majority, they emanated proximal to that point (83%) from the middle part (anteroposterior axis) of the muscle (62%). The intramuscular course of the perforators was easily followed and few muscular branches were encountered, before they joined the main vascular pedicle. A sensory branch of the anterior obturator nerve, accompanying the perforators, was occasionally found (29%). Finally, a superficial vein, branch of the greater saphenous, was always found within the skin territory of the flap in all dissections performed in cadavers.
另一种穿支皮瓣，即股薄肌穿支皮瓣，最近已被纳入重建外科医生的手术器械库。本研究对该皮瓣的解剖结构进行了详细研究。对47具尸体进行了解剖，并对因各种重建原因而进行股薄肌切取的临床病例进行了研究。根据我们的研究结果，在大多数解剖操作（87%）中发现至少有一支大口径的肌皮穿支，其发自股薄肌近端三分之一处。所有穿支均位于距股薄肌主要血管蒂入口点7厘米的范围内。其中大多数穿支（83%）发自肌肉中部（前后轴）且在该点近端（62%）。穿支在肌肉内的走行很容易追踪到，在它们汇入主要血管蒂之前，很少遇到肌肉分支。偶尔会发现一支闭孔前神经的感觉支伴随穿支走行（29%）。最后，在对所有尸体进行的解剖中，在皮瓣的皮肤区域内总能发现一支大隐静脉的浅表分支。
