Cao Zilong, Liu Liqiang
No.1 Department of Scar and Wound Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Dec 15;36(12):1534-1541. doi: 10.7507/1002-1892.202208113.
To summarize and discuss the key factors affecting the hemodynamics in the distal end of the multi-territory perforator flap, so as to provide a theoretical basis for the follow-up research and clinical application in this field.
The related recent literature about multi-territory perforator flaps was extensively reviewed, and the concepts and researches of perforasome, choke vessel zone, arterial super-charge, and venous super-drainage were summarized.
The multi-territory perforator flap is composed of multiple perforasomes, and there are different types of vascular anastomosis in the choke vessel zones, which have important impacts on the hemodynamics of the flap. In order to ensure the survival of the multi-territory perforator flap, arterial super-charge and venous super-drainage are mainly used in clinical practice. However, no consensus has been reached on the choice of the two techniques. The different distribution of blood vessels in the flap, the number of perforasomes, and the type of vascular anastomosis may be the main reasons for the different results.
The location, diameter, and axial characteristics of perforators, the number of perforasomes, and the type of vascular anastomosis are the key factors affecting the hemodynamics of the multi-territory perforator flaps, which should be paid attention to in preoperative design and surgical procedure.
总结并探讨影响多区域穿支皮瓣远端血流动力学的关键因素,为该领域的后续研究及临床应用提供理论依据。
广泛查阅近期关于多区域穿支皮瓣的相关文献,总结穿支体、阻断血管区、动脉增压及静脉超引流的概念及研究。
多区域穿支皮瓣由多个穿支体组成,阻断血管区内存在不同类型的血管吻合,对皮瓣血流动力学有重要影响。为确保多区域穿支皮瓣存活,临床主要采用动脉增压和静脉超引流,但两种技术的选择尚未达成共识。皮瓣内血管分布不同、穿支体数量及血管吻合类型可能是导致结果不同的主要原因。
穿支的位置、直径及轴向特征、穿支体数量和血管吻合类型是影响多区域穿支皮瓣血流动力学的关键因素,在术前设计和手术操作中应予以重视。