Giessler Goetz A, Friedrich Patricia F, Shin Richard H, Bishop Allen T
Department of Orthopedic Surgery, Microvascular Research, Mayo Clinic, Rochester, MN 55905, USA.
Microsurgery. 2007;27(6):560-4. doi: 10.1002/micr.20413.
In reconstructive surgery, fascial flaps provide thin, pliable tissue for mucosal closure or serve as a highly vascularized support for skin grafts. Their angiogenic potential is used for experimental neovascularization of avascular tissue grafts. However, most fascial flaps in animal surgery have random pattern design with short reach. As a pilot study for a femur revascularization project in rabbits, a new axial fascial flap is described based on the superficial inferior epigastric (SIE) vessels. They were used in this species previously only as ligated bundles or in fasciocutaneous flaps. The topographical anatomy of the SIE-vessels, lower abdominal fascia, and panniculus carnosus are outlined. The angiogenic capabilities are demonstrated microangiographically by abundant vessel formation in a femur allograft. Used in a pedicled fashion, this flap is an alternative to femoral and saphenous vessels for prefabrication or revascularization procedures in the lower abdomen, genital area, and thigh. Distant recipient sites seem possible with microsurgical transfer.
在重建外科手术中,筋膜瓣可为黏膜闭合提供薄而柔韧的组织,或作为皮肤移植的高血运支持。其血管生成潜能可用于无血管组织移植的实验性新生血管形成。然而,动物手术中的大多数筋膜瓣采用随意型设计,覆盖范围短。作为兔股骨血运重建项目的一项初步研究,本文描述了一种基于腹壁下浅(SIE)血管的新型轴型筋膜瓣。此前在该物种中,这些血管仅作为结扎束或用于筋膜皮瓣。文中概述了SIE血管、下腹筋膜和腹直肌鞘的局部解剖结构。通过股骨同种异体移植中丰富的血管形成,微血管造影显示了其血管生成能力。以带蒂方式使用时,该筋膜瓣可替代股血管和隐静脉,用于下腹部、生殖器区域和大腿的预制或血运重建手术。通过显微外科转移,远处受区似乎也是可行的。