Stagno D'Alcontres F, Papalia I, Cabula C
Unsegnamento di Chirurgia Plastica, Università degli Studi, Cagliari.
Minerva Chir. 1996 Nov;51(11):945-51.
Among the varying forms of cutaneous flaps, V-Y flaps are finding an increasingly wide application in reconstructive surgery. Their use has been extended, depending on the cutaneous area in question, to various sizes of loss of substance. According to the type of tissues involved, the peduncle may be adipose, fascial or muscular. Vascularisation is random, but in those cases in which the base consists of muscle fascia an axial type is used since the peduncle generally corresponds to a well-known artery. V-Y flaps can repair defects measuring upto 5 cm in diameter and also guarantee a rotation of upto 90 degrees. The authors report their experience of 134 cases in which V-Y flaps were used in the reconstruction of loss of substance localised on the face, upper limbs, trunk, gluteal region, ear, leg and foot. The underlying pathologies consisted mainly of skin cancers, loss of substance following injury, scar retractions, syndactylia, decubitus ulcers in the gluteal region and a trophic foot ulcer. It was not necessary to re-operate any patient owing to problems linked to retraction or the unsightly appearance of residual scars. In the past V-Y flaps were indicated above all for the reconstruction of loss of face substance, but their use today has been extended to other districts. The authors highlight the advantages offered by V-Y flaps: ease and rapidity of use, the characteristics of the skin graft are identical to that removed, and the preservation of sensitivity.
在各种类型的皮瓣中，V-Y皮瓣在重建手术中的应用越来越广泛。根据所涉及的皮肤区域，其应用范围已扩展到各种大小的组织缺损。根据所涉及的组织类型，蒂可以是脂肪性、筋膜性或肌肉性的。血供是随意性的，但在那些蒂由肌筋膜组成的情况下，由于蒂通常对应于一条知名动脉，所以采用轴型。V-Y皮瓣可修复直径达5厘米的缺损，并且还能保证高达90度的旋转。作者报告了他们使用V-Y皮瓣重建面部、上肢、躯干、臀区、耳部、腿部和足部组织缺损的134例经验。潜在的病理情况主要包括皮肤癌、损伤后组织缺损、瘢痕挛缩、并指畸形、臀区褥疮和足部营养性溃疡。由于与挛缩或残留瘢痕外观不佳相关的问题，没有必要对任何患者进行再次手术。过去，V-Y皮瓣主要用于重建面部组织缺损，但如今其应用已扩展到其他部位。作者强调了V-Y皮瓣的优点：使用简便快捷、皮瓣的特性与切除的皮肤相同以及保留感觉功能。
