Worseg A P, Kuzbari R, Hübsch P, Koncilia H, Tairych G, Alt A, Tschabitscher M, Holle J
Department of Plastic and Reconstructive Surgery, Wilhelminenhospital, Vienna, Austria.
Plast Reconstr Surg. 1997 Apr;99(5):1368-80; discussion 1381. doi: 10.1097/00006534-199704001-00026.
Fascia and fascia-subcutaneous flaps are thin, pliable, and well-vascularized tissue with aesthetic and functional advantages, particularly for the extremities and in the head and neck region. Although various donor sites have been used for these flaps, there is an occurrence of unsatisfactory donor-site defects that are often complicated by conspicuous, widened scars or alopecia. In addition, flap elevation is sometimes prolonged because of the demanding operative procedures as well as the impossibility of a two-team approach. In this anatomic and clinical study we present a new fascial flap that results in a minimal donor-site defect and a short and easy operative procedure. Scarpa's fascia, which can be used as both a free and a pedicled flap, is a well-defined single membranous sheet within the subcutaneous tissue layer at the lower abdominal wall. We studied its distribution, structure, and vascular supply in 27 fresh cadaver specimens. In addition, computed tomographic (CT) and ultrasound studies were performed in 13 healthy volunteers and in 3 cadavers before and after injection of diluted contrast material in the superficial epigastric artery. Finally, histologic examinations were done with hematoxylin and eosin or with reticulum and elastin. Our studies showed that Scarpa's fascia provides a thin, pliable, and well-vascularized flap pedicled on the superficial epigastric artery. After successful application of the Scarpa's fascia flap as a free flap in 3 patients and as a pedicled option in 1 patient, we can recommend this flap as a valuable tool for the reconstructive surgeon.
筋膜和筋膜下皮瓣是薄而柔韧、血供良好的组织，具有美学和功能优势，尤其适用于四肢以及头颈部区域。尽管这些皮瓣有多种供区可供选择，但供区缺损往往不尽人意，常伴有明显增宽的瘢痕或脱发等并发症。此外，由于手术操作要求高且无法采用双组手术方式，皮瓣掀起有时会耗时较长。在这项解剖学和临床研究中，我们介绍一种新的筋膜皮瓣，其供区缺损极小，手术操作简短且简便。斯卡帕筋膜可作为游离皮瓣和带蒂皮瓣使用，是下腹壁皮下组织层内一层界限清晰的单层膜状结构。我们在27具新鲜尸体标本上研究了其分布、结构和血供。此外，对13名健康志愿者和3具尸体在注入稀释造影剂至腹壁浅动脉前后进行了计算机断层扫描（CT）和超声检查。最后，用苏木精和伊红或网状纤维和弹性纤维进行了组织学检查。我们的研究表明，斯卡帕筋膜可提供一个以腹壁浅动脉为蒂的薄而柔韧、血供良好的皮瓣。在成功将斯卡帕筋膜皮瓣作为游离皮瓣应用于3例患者并作为带蒂皮瓣应用于1例患者后，我们推荐该皮瓣作为重建外科医生的一种有价值的工具。
