Fujimoto Y, Hamamura Y, Inoue K, Shirasuna K, Urade M, Sugiyama M, Kogo M, Uchida Y, Matsuya T
Osaka Daigaku Shigaku Zasshi. 1989 Dec;34(2):370-7.
The radial forearm flap, or the forearm flap, is called "Chinese flap" for its development of the chinese doctors, and is originally designed for the correction to the post-burn contraction of the face and neck. The radial forearm flap is one of the fasciocutaneous flap, supplied by the radial artery, and transferred as a single-stage reconstruction micro-surgically. In oral and maxillofacial region, the deltopectral flap (D-P flap) and the pectralis major myocutaneous flap (P-M-M-C flap) are mainly used for the reconstruction. These flaps, however, are sometimes too bulky and limited to transfer, and more require two-stage operations. On the other hand, as the forearm flap being thin and pliable, some doctors use this flap micro-surgically at single-stage free flap reconstruction. Before two years, we have begun to transfer the radial forearm flap for the intra-oral reconstruction. The operation method is as follows. Design and Elevation of the Radial Forearm Flap 1. Using the ultrasonic doppler flow meter, the radial artery and the subcutaneous forearm veins are marked on the skin. 2. The flap is designed 20% larger according to the pattern to be reconstructed, with the distal section of the radial artery as an axis on the forearm and the median vein of forearm inclusively. 3. Before the operation, Allen test must be performed in order to determine whether the hand will survive without a radial arterial in-put. 4. The operation is performed with a arm tourniquet. The margin of the flap are incised down to the deep fascia, isolating and preserving the proximal subcutaneous veins as required.(ABSTRACT TRUNCATED AT 250 WORDS)
桡侧前臂皮瓣,即前臂皮瓣,因其由中国医生发展而来,被称为“中国皮瓣”,最初设计用于矫正面颈部烧伤后挛缩。桡侧前臂皮瓣是一种由桡动脉供血的筋膜皮瓣,通过显微外科技术进行一期转移重建。在口腔颌面部区域,主要使用三角胸皮瓣(D-P皮瓣)和胸大肌肌皮瓣(P-M-M-C皮瓣)进行重建。然而,这些皮瓣有时体积过大且转移受限,更多需要二期手术。另一方面,由于前臂皮瓣薄且柔韧,一些医生在一期游离皮瓣重建中使用该皮瓣进行显微外科手术。两年前,我们开始采用桡侧前臂皮瓣进行口腔内重建。手术方法如下。桡侧前臂皮瓣的设计与掀起 1. 使用超声多普勒血流仪在皮肤上标记桡动脉和前臂皮下静脉。2. 根据待重建的模型,以前臂桡动脉远端为轴并包含前臂正中静脉,将皮瓣设计得大20%。3. 术前必须进行艾伦试验,以确定在没有桡动脉供血的情况下手部能否存活。4. 手术使用臂部止血带。将皮瓣边缘切开至深筋膜,根据需要分离并保留近端皮下静脉。(摘要截断于250字)