Mohan Anita T, Saint-Cyr Michel
1 Department of Plastic Surgery, Mayo Clinic, Rochester, MN, USA ; 2 Restoration of Appearance and Function Trust, RAFT, UK.
Gland Surg. 2015 Apr;4(2):116-33. doi: 10.3978/j.issn.2227-684X.2015.04.01.
The success of autologous tissue transfer is reliant on adequate blood supply and as we endeavour to tailor our reconstructive options through our flap choices and design. Autologous breast reconstruction has made substantial progress over the years and the evolution of refinements over the last 30 years has allowed flaps to be based on specific perforators. The ultimate goal of breast reconstruction following mastectomy is to match optimal tissue replacement with minimal donor-site expenditure. In parallel surgeons will seek ways to ensure safe flap design and harvest while maintaining predictability and reliable tissue perfusion. Better understanding of the vascular anatomy and physiology of the cutaneous circulation of soft tissues, and that of patterns of blood flow from individual perforator has provided insight to advance perforator flap harvest and modifications in flap design. The aim of this article is to review the principles of blood supply and flap design exemplified through common flaps used in autologous breast reconstructive surgery, to better understand approaches for safe flap harvest and transfer of well perfused tissue.
自体组织移植的成功依赖于充足的血液供应，并且我们努力通过皮瓣选择和设计来定制重建方案。多年来，自体乳房重建取得了重大进展，过去30年的改进使得皮瓣能够基于特定的穿支血管。乳房切除术后乳房重建的最终目标是以最小的供区代价实现最佳的组织替代。与此同时，外科医生将寻求方法，在确保安全的皮瓣设计和切取的同时，维持可预测性和可靠的组织灌注。对软组织皮肤循环的血管解剖学和生理学以及单个穿支血管血流模式的更好理解，为推进穿支皮瓣切取和皮瓣设计的改进提供了思路。本文旨在回顾通过自体乳房重建手术中常用皮瓣所体现的血液供应和皮瓣设计原则，以更好地理解安全切取皮瓣和转移血运良好组织的方法。
