带血管蒂的组织瓣移位术与设计原则正稿教程.ppt

皮 瓣 类 型Classification of skin flaps 随意皮瓣 Random flap 筋膜皮瓣与筋膜瓣 Fasciocutaneous flap and fascia flap 轴形皮瓣 Axial flap 肌皮瓣与肌瓣 musculocutaneous flap and muscle flap 筋 膜 皮 瓣 Fasciocutaneous flap 手 术 要 点 Operation outline 肌皮瓣 musculocutaneous flap 皮瓣设计 Design of the flap 点 旋转轴 Point－axis to transfer flaps 线 轴心线 Line－ axal line of the flap 面 血供范围 Range－extent to which the nutritional vessel can supply 弧 旋转弧 Arc－boundary that the flap can reach 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 deep tissues caused by scar excision and malformation rectification 手术指征 Indication 需在瘢痕或窦道区进行骨、关节、 肌腱手术者 Operations on bone, joint or tendons in regions of scars and sinuses 慢性骨髓炎病灶清除后有创面裸露 Cavities of Supercilious ulcer, purulent osteomyelitis and bedsore that need to be cleaned up in phade 1 after thorough treatment. 感觉、运动功能重建及某些器官再造 Wounds repair with simultaneous reconstruction of motor or nerve function. 手术指征 Indication 对供区功能、外观影响较小 The flap with less affect to donor site. 血管恒定、变异少，易于切取 The flap acquired easily and with less variable vessles 根据受区部位、大小、创面性质及 功能要求选择皮瓣 The flap suit for recipient site in position, size, quality and function . 皮瓣选择 Selection of flap 邻近创面的皮瓣，质地近似，转移方便，应优先选用 The preferable flap with the character of adjacent to the recipient site, having similar texture and thickness and easily transferred 根据受区部位选择皮瓣 Selection of flap according to recipient site 足底皮瓣 Plantar flap of foot 足背皮瓣 Dorsal flap of foot 小腿皮瓣 Crural flap 足跟创面 calcaneal defect 无骨和肌肉缺损的创面，选用轴型皮瓣 The axial flap —— suitable for wound without defect of bone and muscle 有骨或肌肉缺损的创面选用肌皮瓣较好 The musculocutaneous flap —— suitable for wound with defect of bone and muscle 根据