南方医科大学学报

南方医科大学学报 ›› 2004, Vol. 24 ›› Issue (05): 489-492.

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胸脐皮瓣的应用(附33例报告)

张杏泉, 王少东, 范清宇, 马保安, 李钊   

  1. 第四军医大学唐都医院全军骨肿瘤研究所, 陕西, 西安, 710038
  • 出版日期:2004-05-20 发布日期:2004-05-20
  • 基金资助:
    作者简介:ZHANG Xing-quan (1969- ), MD, attending surgeon, specialized in basic clinical research of skeletal trauma and microsurgery, ZHANG Xing-quan:Tel: 029-83377733,ZHANG Xing-quan:E-mail: zhxqsd@fmmu.edu.cn

Thoraco-umbilical flap: experience with 33 cases

ZHANG Xing-quan, WANG Shao-dong, FAN Qing-yu, MA Bao-an, LI Zhao   

  1. 第四军医大学唐都医院全军骨肿瘤研究所, 陕西, 西安, 710038
  • Online:2004-05-20 Published:2004-05-20

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摘要： 1996年8月~2000年6月,我们采用胸脐皮瓣修复各种软组织缺损共33例,主要适应征是四肢复杂创伤或软组织肿瘤切除后所遗较大缺损,急诊或二期手术均可。胸脐皮瓣的血供主要源于腹壁下动脉的脐旁最大皮穿支——胸脐支,后者于脐旁2 cm穿出斜向肩胛下角方向与后肋间动脉吻合。皮瓣切取时先于腹直肌外下缘解剖腹壁下动脉,向下追至髂外动脉、向上于腹直肌内锐性分离腹壁下动脉,直至脐旁支处。受区感染创面或需肌肉填塞空腔,可携带部分腹直肌。待受区血管解剖完毕再断蒂,血管蒂尽可能长。本组切取皮瓣长度10~40 cm,宽度8~25 cm。33例均成活,成活率100%。供区皮瓣宽度10~12 cm以内者可直接缝合,瘢痕不易觉察。皮瓣宽度超过10~12 cm者,需植皮。术后随访2年,皮瓣无异常,供区创伤亦较小。胸脐皮瓣血管蒂解剖恒定且血管蒂较长、血管口径较粗、供皮范围较大,是修复四肢大面积软组织缺损的较好皮瓣。

Abstract: From August, 1996 to June, 2000, 33 patients received transfer of free thoraco-umbilical flaps for repair of various soft-tissue defects. The size of the flaps ranged from 10 to 40 cm in length and 8 to 25 cm in width, with blood supply of the flaps derived from the largest periumbilical perforating branch of the deep inferior epigastric vessels. The indications of this flap included complex extremity trauma or large skin loss resulted from soft tissue tumor resection, either acute or postprimary. The overall success rate was 100% in the 33 cases. The donor area was closed directly with 10- to 12-cm-wide flaps, leaving an inconspicuous scar, whereas larger flaps required skin grafting. A 2-year follow-up found uneventful healing of all the flaps with minimal donor abdominal morbidity.

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