Hinman F
Department of Urology, University of California, School of Medicine, San Francisco 94143-0738.
J Urol. 1991 Jun;145(6):1232-5. doi: 10.1016/s0022-5347(17)38584-1.
The prepuce is formed by a combination of folding and epithelial proliferation, and separates from the glans after it has developed a blood supply. The arterial input, through 4 branches from the external pudendal arteries, is terminal and after birth supplies the outer and inner preputial surfaces in succession. Similarly, the venous return arises from small veins running transversely in the prepuce that connect to larger subcutaneous veins along the dorsal aspect of the shaft. Because the 2 preputial surfaces have a single blood supply they must be treated as 1 unit. Unfolding the prepuce leaves the former inner segment with only a terminal blood supply. The pedicle containing the superficial blood supply must remain attached to the skin flap or it will be devascularized. However, since this circulation goes exclusively to the flap, the more proximal portion of the prepuce that was raised to form the pedicle becomes ischemic when used as ventral cover. A double-faced flap avoids this complication.
包皮由折叠和上皮增殖共同形成，在形成血供后与龟头分离。其动脉血供通过来自阴部外动脉的4个分支，为终末供血，出生后依次供应包皮外表面和内表面。同样，静脉回流来自包皮内横向走行的小静脉，这些小静脉与阴茎干背侧的较大皮下静脉相连。由于包皮的两个表面有单一血供，因此必须将它们视为一个单位。展开包皮后，原来的内段仅保留终末血供。包含浅表血供的蒂必须保持与皮瓣相连，否则皮瓣会缺血。然而，由于这种循环仅供应皮瓣，当用于腹侧覆盖时，为形成蒂而掀起的包皮近端部分会缺血。双面皮瓣可避免这种并发症。
