Lyons A J
Department of Oral & Maxillofacial Surgery, Guy's Hospital Tower, London SE1 9 RT, UK.
Int J Oral Maxillofac Surg. 2006 Mar;35(3):199-207. doi: 10.1016/j.ijom.2005.07.015. Epub 2005 Nov 15.
A 'perforator flap' is a flap of skin or subcutaneous tissue that is based on the dissection of a 'perforating vessel'. Over the past few years a large number of 'perforator flaps' have been devised and described. By reducing any muscle harvest and trauma to a minimum, perforator flaps aim to minimize donor site morbidity whilst providing the reconstructive surgeon with more versatility than other flap types. The principal perforator flaps are discussed, particularly those employed in head and neck reconstruction including 'free style perforator flaps'. Methods of locating perforating vessels for the use of perforator flaps are described. The technique of perforator flap harvest is illustrated as exemplified in the anterolateral thigh perforator flap. Advantages in the use of this flap for head and neck reconstruction are discussed and are compared with that of non-perforator flaps, particularly the Radial Forearm Flap. The role of the primary thinning of perforator flaps is discussed. The versatility of the anterolateral flap is discussed, which may well supersede the Radial Forearm Flap as the principal soft tissue flap used in head and neck surgery.
“穿支皮瓣”是一种基于“穿支血管”解剖的皮肤或皮下组织皮瓣。在过去几年中，已经设计并描述了大量的“穿支皮瓣”。通过将肌肉切取和创伤降至最低，穿支皮瓣旨在将供区并发症降至最低，同时为重建外科医生提供比其他皮瓣类型更多的灵活性。本文讨论了主要的穿支皮瓣，特别是那些用于头颈部重建的皮瓣，包括“游离式穿支皮瓣”。描述了用于穿支皮瓣的穿支血管定位方法。以股前外侧穿支皮瓣为例，说明了穿支皮瓣切取技术。讨论了该皮瓣用于头颈部重建的优势，并与非穿支皮瓣，特别是桡侧前臂皮瓣进行了比较。讨论了穿支皮瓣一期减薄的作用。讨论了股前外侧皮瓣的灵活性，它很可能会取代桡侧前臂皮瓣，成为头颈部手术中主要使用的软组织皮瓣。
