May J W, Toth B A, Cohen A M
Plast Reconstr Surg. 1982 Feb;69(2):326-8. doi: 10.1097/00006534-198202000-00025.
The complete survival of a teres major--latissimus dorsi skin-muscle flap for chest reconstruction is reported in a patient in whom the primary neurovascular pedicle of the latissimus muscle had previously been sacrificed. At operation, collateral vessels of 1-mm proportions were noted to have developed between the innervated teres major and denervated latissimus dorsi muscle. In this case, the teres major muscle rotated with the latissimus muscle to affect reconstruction of a full-thickness anterior chest resection. This report suggests the possibility of a denervated, relatively devascularized muscle obtaining additional blood supply from adjacent innervated vascularized muscles and supports the concept of rotating the muscles as a unit to encourage viability of the denervated component.
据报道，一名患者在之前已牺牲背阔肌的主要神经血管蒂后，用于胸部重建的大圆肌 - 背阔肌皮瓣完全存活。手术时，发现支配的大圆肌和失神经支配的背阔肌之间出现了直径为1毫米的侧支血管。在该病例中，大圆肌与背阔肌一起旋转，以完成全层前胸切除的重建。本报告表明，失神经支配且相对血运减少的肌肉有可能从相邻的有神经支配的血管化肌肉获得额外的血液供应，并支持将肌肉作为一个单元旋转以促进失神经支配部分存活的概念。
