Chai Yi-min, Lin Chong-zheng, Qiu Xun-yong, Chen Han-dong, Wang Kuai-sheng, Chen Yan-kun
Department of Orthopaedics, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2006 Jan;22(1):34-7.
To report the operative technique and clinical results of the neurocutaneous vascular axial flap with perforating vessels as its pedicle.
An axial skin flap was designed along the axis of small paraneural vessels that was close to a concomitant cutaneous nerve. The cutaneous perforating branches of major arteries were used as the pedicle, which provided a rotation arc for the flap to cover the defects in the distal site of extremities. 43 neurocutaneous vascular axial flaps were transferred, including 13 sural neurocutaneous axial flaps (30 cm x 12 cm to 16 cm x 8 cm) supplied by perforating branches of the peroneal vessel; 9 saphenous neurocutaneous axial flaps (15 cm x 8 cm to 5 cm x 4 cm) with posterior tibial perforators as the pedicle; 8 posterior antebrachial neurocutaneous axial flaps (16 cm x 6 cm to 10 cm x 4 cm) based on the dorsal branch of the anterior interossea vessel and 13 reversed neurocutaneous axial flaps (6.0 cm x 3.5 cm to 2.5 cm x 1.5 cm) on the dorsal hand pedicled with the perforators at the interdigital web space.
42 flaps survived completely. One flap underwent venous congestion with necrosis on the distal one fourth of the flap. The color and texture of the flaps were good. The appearance and functional results were satisfactory as revealed by follow-up for 6 to 24 months.
The modified operation combines the advantages of both the perforator flap and the neurocutaneous axial flap, enlarges the size of the flap and extends the scope of reconstruction. The flap is characterized with delicate designation, easy dissection and reliable blood supply. It is a good method in repairing the skin defects of the extremities.
报道以穿支血管为蒂的神经皮血管轴型皮瓣的手术技术及临床效果。
沿与伴行皮神经相邻的小神经旁血管轴设计轴型皮瓣。以主要动脉的皮穿支为蒂，为皮瓣提供旋转弧以覆盖肢体远端缺损。共转移43例神经皮血管轴型皮瓣，其中腓血管穿支供血的腓肠神经皮血管轴型皮瓣13例（30 cm×12 cm至16 cm×8 cm）；以胫后穿支为蒂的隐神经皮血管轴型皮瓣9例（15 cm×8 cm至5 cm×4 cm）；以骨间前血管背侧支为蒂的前臂后侧神经皮血管轴型皮瓣8例（16 cm×6 cm至10 cm×4 cm）；以指蹼间隙穿支为蒂的手背逆行神经皮血管轴型皮瓣13例（6.0 cm×3.5 cm至2.5 cm×1.5 cm）。
42例皮瓣完全存活。1例皮瓣出现静脉淤血，皮瓣远端四分之一坏死。皮瓣颜色和质地良好。随访6至24个月，外观和功能效果满意。
改良手术结合了穿支皮瓣和神经皮血管轴型皮瓣的优点，扩大了皮瓣面积，拓宽了修复范围。该皮瓣设计精巧，解剖容易，血供可靠。是修复肢体皮肤缺损的良好方法。
