Methods Based on the anatomical studies, series flaps include the medialis pedis island flap, instep island falp, the combined flap and the hifoliated flap pedicle with the medial plantar artery and its cutaneous branches were designed, the proximally or distally based island flaps and free flaps were used to resurfacing 53 cases with skin and soft tissue defects of the hand and foot.
After drastically debriding, the wound was repaired through transplanting combined flap that was anstomosed a set of blood vessels. The 6 types flaps were selected, it demonstrated signs of adequate circulation. The longest was 70cm,the largest was 42×24cm.
Objective To investigate the clinical result in repair of soft tissue defect with combined skin flap vascularized by pedicle on the one end and vascular anastomosis on the other end.
Methods From October 1990 to August 1995, 5 cases with soft tissue defect at the extremities and 1 cases with sacral bed sore were repaired by the combined skin flaps transfer, ranged from 15 cm×30 cm to 16 cm×70 cm in defect, among them, 5 cases with myocutaneous flap and 1 case with skin flap, and the size of the combined skin flaps was 15 cm×40 cm to 12 cm×80 cm.
方法 1990 年10 月1995 年8 月应用联合皮瓣技术修复5 例肢体软组织缺损和1 例骶部褥疮,缺损范围为15 cm ×30 cm 16 cm ×70 cm 。 其中5 例应用肌皮瓣,1 例应用皮瓣。
[Method]A total of 26 cases were operated with combination of a single group anastomotic blood vessel with flaps. In all the cases, the longest flap was 70 cm, the largest flap was 1 008 cm2 (42 cm ×24 cm) , which was to repair the wound with super areas of (60 × 10) cm ~ (38 ×20) cm.
In harvesting the combined flap, the latissimus dorsi is usually elevated first.
Thus, the combined flap can be helpful in reconstructing complex three-dimensional composite defects of the head and neck.
Three cases will be described in detail to illustrate the use of this combined flap in reconstructing scalp, midface, and oromandibular defects.
The origin. external-caliber. length, course. branches and anastomosis of the cutaneous arteries (CA) of the lateral thoracic-abdominal skin flaps were studied in 34 cases(sides). The chief resulfs are as follows: (1) By seventh rib every skin flap may be divided into two parts: the upper part and lower part. (2) CA within the upper part of skin flap devive from the branches of axillary artery and brachial artry. Their Course are all longitudinal. The number of CA in every skin flap averages 3. Lateral thoracic...
The origin. external-caliber. length, course. branches and anastomosis of the cutaneous arteries (CA) of the lateral thoracic-abdominal skin flaps were studied in 34 cases(sides). The chief resulfs are as follows: (1) By seventh rib every skin flap may be divided into two parts: the upper part and lower part. (2) CA within the upper part of skin flap devive from the branches of axillary artery and brachial artry. Their Course are all longitudinal. The number of CA in every skin flap averages 3. Lateral thoracic CA. thoracodorsal CA and subscapula(?) CA. predominate. (3) CA within the lower part of skin flap derive from 7-12th lateral cutaneous branches of intercostal artery. Their course correspond with the intercostal space. (4) CA within the skin flap of upper and lowev part send out branches and form an arterial network which spreads all sver the whole skin flap. (5) External-calibers and lengths of accompanied weins are larger than the corresponding CA. The veins within the upper part of skin flap. especial the thoraco-epigastric vein which drainges blood into the lateral thoracic cutaneous veins may extend to the lower part of skin flap. (6) The cutaneous veins within the skin flap form an veins network which spreads all over the whole skin flap also.
The medial plantar flap and medial pedal flap were studied on 42 sides ofadult specimens. The result shows that the medial plantar artery could be takenas the pedicle for the united flaps of the medial plantar flap and medial pedalflap; its deep branch is the axial vessel of the medial plantar flap and its super-ficial branch is the axial vessel of the medial pedal flap.
An operative technique of vaginal re-construction by labium minimum flap andposterior combined flap was introduced。Clin-ical application in six cases has shown satis-factory result。The author declared that itwas an ideal technique for vaginoplasty withadvantages of obtaining material easily,mini-mal trauma, thin soft and mucoid flap withsensation, high survival rate, and few con-tractures postoperatively。
联合皮瓣
combined flap
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