Penington A J, Theile D R, MacLeod A M, Morrison W A
Bernard O'Brien Microsurgery Research Institute, St Vincent's Hospital, Fitzroy, Melbourne, Australia.
Scand J Plast Reconstr Surg Hand Surg. 1996 Dec;30(4):299-305. doi: 10.3109/02844319609056408.
Reconstruction of a full thickness defect of the abdominal or chest wall requires a combination of a rigid or semi-rigid layer and skin cover. The tensor fasciae latae (TFL) flap is unique in that it provides both of these in substantial quantities, but the most difficult aspect of using this flap in the anterior chest and abdomen is finding suitable recipient vessels. We describe a series of nine cases in which full thickness defects of the chest and abdominal wall were repaired using free vascularised TFL flaps. The recipient vessels included the gastroepiploic vessels (n = 2), the deep inferior epigastric artery (n = 3), the internal mammary artery (n = 2), and the superior thyroid and acromiothoracic arteries (n = 1 each). The gastroepiploic and internal mammary vessels are preferred because of their reliability and because the flap pedicle enters the centre of the deep surface of the flap so that if these vessels are used, circumferential tight closure of the fascial layer can be achieved, with consequent decreased risk of vessel kinking and future herniation.
腹壁或胸壁全层缺损的修复需要刚性或半刚性层与皮肤覆盖相结合。阔筋膜张肌（TFL）皮瓣的独特之处在于它能大量提供这两者，但在前胸部和腹部使用该皮瓣最困难的方面是找到合适的受区血管。我们描述了一系列9例使用游离带血管蒂阔筋膜张肌皮瓣修复胸壁和腹壁全层缺损的病例。受区血管包括胃网膜血管（2例）、腹壁下深动脉（3例）、胸廓内动脉（2例）以及甲状腺上动脉和胸肩峰动脉（各1例）。胃网膜血管和胸廓内血管是首选，因为它们可靠，而且皮瓣蒂进入皮瓣深面的中心，所以如果使用这些血管，可以实现筋膜层的周向紧密闭合，从而降低血管扭结和未来疝形成的风险。
