侯春林教授主题：带血管蒂的组织瓣移位术解剖与设计原则正稿.ppt

第二军医大学长征医院骨科 Department of Orthopaedic Surgery, Changzheng Hospital, Shanghai 侯 春 林 HOU Chun-lin ;带血管组织瓣移位术是以组织瓣的营养血管为蒂，通过局部转移来修复临近组织缺损 。 The transfer of cutaneous, myocutaneous and muscle flaps with vascular pedicle is a surgical skill to reconstruct adjacent tissue defect. The pedicels of these flaps are their nutritional blood vessels. ;由于几乎全身所有部位皮肤均可形成皮瓣、肌皮瓣，这就使全身任何部位创面均可采用带血管蒂组织瓣移位术治疗。 The flap can be acquired from every anatomic region of the body. So this make all defects can be reconstructed by transferring of vascular pedicle flaps.;与吻合血管的游离组织移植相比，此项技术不需吻合血管，方法简便、安全、成功率高， 现已用于外科各个领域。 Contrasting with dissociative tissue flaps, it is not required to connect vessels by anastomosis in transfer of flaps with vascular pedicle. This technic is simple and safe. It has being applied in every surgical field.;带血管蒂的皮瓣、肌（皮）瓣转移术是把带有血管蒂的皮瓣、肌（皮）瓣，通过局部转移的方法，来修复邻近组织缺损 The transfer of cutaneous, myocutaneous and muscle flaps with vascular pedicle is a surgical skill to reconstruct adjacent tissue defect by local displacement. ;Blood supply of skin;直接皮动脉 direct cutaneous artery;肌皮动脉 musculocutaneous artery;Blood supply of muscle;Blood supply of muscle;Blood supply of fascia profunda;筋膜上血管丛 Vascular plexus up-fascia;皮 瓣 类 型Classification of skin flaps ;筋 膜 皮 瓣 Fasciocutaneous flap;筋膜皮瓣 Fasciocutaneous flap;筋膜皮瓣 Fasciocutaneous flap;翻 转 筋 膜 瓣 Reversal fasciocutaneous flap;;轴 型 皮 瓣 Axial flap;轴型皮瓣 Axial flap;;;轴型皮瓣 Axial flap;肌 皮 瓣 Musculocutaneous flap;;;;肌肉皮肤蒂肌皮瓣 Musculocutaneous flap with musculocutaneous pedicle;肌肉皮下组织蒂肌皮瓣 Musculocutaneous flap with musculosubcutaneous pedicle;肌肉蒂肌皮瓣 Musculocutaneous flap with muscle pedicle ;血管神经蒂岛状肌皮瓣 Musculocutaneous island flap with vasonerval pedicle;;;肌皮瓣 musculocutaneous flap;皮瓣设计 Design of the flap ; Axis and arc of flap;创伤、溃疡、肿瘤切除所致软组织缺损 Soft tissue defect of any causes that could not be reconstructed through conventional methods 四肢瘢痕挛缩畸形，切除瘢痕、矫正畸形有深部组织裸露 Malformation caused by scar crispation, bare de