Zhao Yan, Yang Zonglin, Chen Lifen, Peng Yuhui
Department of Dermatology Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China.
Front Surg. 2022 Oct 12;9:988783. doi: 10.3389/fsurg.2022.988783. eCollection 2022.
A-T flap has been extensively applied to repair dermal soft tissue defects. The flap design completely depends on the experience of doctors. Herein, we explored the approach of analyzing the reasonability of A-T flap design and performed a simulation of operation processes by computer-aided technology. Afterward, the finite element analysis software (MSC.Marc/Mentat) was used to establish the simulation model, based on which the computer simulation of flap suturing and release state in A-T flap surgery was performed.
A geometrical model of the A-T flap was established, and the length-width ratio of the flap, maximum suture distance, and suture area that could influence the postoperative suture effects of the flap were analyzed. The reasonable surgical planning for A-T flap design based on the crossing constraint relationship was achieved. The simulation model was established by the finite element analysis software (MSC.Marc/Mentat), based on which computer simulation of flap suture and release state of A-T flap in surgery processes were performed. The flap's stress and deformation distribution results confirmed the applicability of the A-T flap design method proposed in the present study.
When the apex angle of the A-T flap was 60 degrees, the suture area was the smallest, and the flap design had the highest practicability.
Computer-assisted preoperative assessment, which has high clinical value, could provide a theoretical basis for A-T flap design in clinical practice.
A - T皮瓣已广泛应用于修复皮肤软组织缺损。皮瓣设计完全依赖于医生的经验。在此,我们探索了分析A - T皮瓣设计合理性的方法,并通过计算机辅助技术对手术过程进行模拟。随后,使用有限元分析软件(MSC.Marc/Mentat)建立模拟模型,在此基础上对A - T皮瓣手术中的皮瓣缝合和松解状态进行计算机模拟。
建立A - T皮瓣的几何模型,分析可能影响皮瓣术后缝合效果的皮瓣长宽比、最大缝合距离和缝合面积。基于交叉约束关系实现了A - T皮瓣设计的合理手术规划。通过有限元分析软件(MSC.Marc/Mentat)建立模拟模型,在此基础上对手术过程中A - T皮瓣的皮瓣缝合和松解状态进行计算机模拟。皮瓣的应力和变形分布结果证实了本研究提出的A - T皮瓣设计方法的适用性。
当A - T皮瓣的顶角为60度时,缝合面积最小,皮瓣设计的实用性最高。
具有较高临床价值的计算机辅助术前评估可为临床实践中A - T皮瓣设计提供理论依据。