Itoh Y, Arai K
Department of Traumatology and Critical Care Medicine, National Defense Medical College, Tokorozawa, Japan.
Plast Reconstr Surg. 1993 Apr;91(5):853-63; discussion 864.
We carried out an anatomic study to create the efficient surgical technique of elevating the inferior epigastric artery free skin flap. The deep inferior epigastric artery bifurcates into the lateral and medial branches. The former usually is larger in diameter and has many skin perforators slightly lateral to the midline of musculature. When a vascular pedicle skin flap is lifted without attaching the rectus abdominis muscle or its anterior sheath, it seems more efficient if the flap uses the skin perforator belonging to the lateral branch. This is so because entry of the inferior epigastric artery is from the lateral side of the rectus abdominis muscle and the lateral branch runs slightly lateral to the midline of the musculature and parallel to the run of the muscular fibers. This would be easier technically and would minimize the damage to the muscle when detaching the lateral branch.
我们开展了一项解剖学研究，以创建一种高效的外科技术，用于提升腹壁下动脉游离皮瓣。腹壁下动脉深层分支为外侧支和内侧支。前者直径通常较大，在肌肉组织中线稍外侧有许多皮肤穿支。当掀起带血管蒂皮瓣而不附着腹直肌或其前鞘时，如果皮瓣采用属于外侧支的皮肤穿支，似乎效率更高。之所以如此，是因为腹壁下动脉从腹直肌外侧进入，外侧支在肌肉组织中线稍外侧走行并与肌纤维走行平行。从技术角度来看，这样操作会更容易，并且在分离外侧支时对肌肉的损伤会最小化。
