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Objective:A free trifoliated flap was designed for repairing the skin defect of multiple fingers.Methods:Based on the anatomical studies,a trifoliated flap composed of medial pedal, first dorsal metatarsal and lateral pedal flaps was designed. The combined flap contained anterior tibial artery and dorsal pedal artey as the stem vessel for anastomosing with the supplying vessel. The three tributaries of dorsal pedal artery:medial tarsal artery, first dorsal metatarsal artey and lateral tarsal artery were contained... Objective:A free trifoliated flap was designed for repairing the skin defect of multiple fingers.Methods:Based on the anatomical studies,a trifoliated flap composed of medial pedal, first dorsal metatarsal and lateral pedal flaps was designed. The combined flap contained anterior tibial artery and dorsal pedal artey as the stem vessel for anastomosing with the supplying vessel. The three tributaries of dorsal pedal artery:medial tarsal artery, first dorsal metatarsal artey and lateral tarsal artery were contained in the three leaves respectively.The trifoliated flap harvested could be used to cover the skin defect of multiple fingers by free transplantation. Results:In the 4 clinically applied cases,3 combined trifoliated flaps survived completely. Two leaves of the rest one necrosed.Conclusion:The free trifoliated flap combining medial pedal,first dorsal metatarsal and lateral pedal flaps provided a new option for the repairing of multipe finger skin defect. 目的:为修复多指皮肤缺损而设计了足内侧,第一趾背、足外侧的三叶皮瓣。方法:在解剖学研究的基础上,设计以胫前、足背血管为主干,跗内侧、第1跖背、跗外侧血管为分支,构成足内侧、第1跖背、足外侧的三叶皮瓣,游离移植修复多指皮肤同时缺损。结果:临床应用4例,3例三叶皮瓣全部成活,1例皮瓣有二叶坏死。结论:足内侧、第1跖背、足外侧三叶皮瓣游离移植的应用成功,为临床多指皮肤缺损的修复,提供了一种新的术式 Objective To study the vascular distribution on the dorsum of the foot and design a new surgical procedure for repair of skin defect of multiple fingers. Methods 10 fresh adult foot specimens were dissected. Red latex was injected into the anterior tibial artery to visualize its distribution in the medial aspect, lateral aspect, and first dorsal metatarsal area of the foot. Based on the anatomical study, a new trifoliated flap harvested from the dorsum of foot,with the dorsalis pedis artery and great scaphenous... Objective To study the vascular distribution on the dorsum of the foot and design a new surgical procedure for repair of skin defect of multiple fingers. Methods 10 fresh adult foot specimens were dissected. Red latex was injected into the anterior tibial artery to visualize its distribution in the medial aspect, lateral aspect, and first dorsal metatarsal area of the foot. Based on the anatomical study, a new trifoliated flap harvested from the dorsum of foot,with the dorsalis pedis artery and great scaphenous vein as its pedicle, was designed to repair the skin defect of multiple fingers.Results The blood supply of the skin in the medial aspect, lateral aspect, and first dorsal metatarsal area of the foot was from anterior medial malleolar artery or medial tarsal artery,anterior lateral malleolar artery or lateral tarsal artery, and the cutaneous branch of first dorsal metatarsal artery, respectively. All these tributaries originated from the dorsalis pedis artery. Conclusions The new vascular pedicled trifoliated flap,with its definite blood supply, is suitable for repair of skin defect of multiple fingers. 目的对足背动脉进行解剖学研究,为设计并应用足背三叶皮瓣提供依据。方法10只新鲜成人足标本,用乳胶灌注后对胫前动脉→足背动脉在足内侧区、第一跖背区、足外侧区的分支进行解剖学观察。结果足内侧区皮肤的血供由足背动脉发出内踝前动脉或跗内侧动脉支配,足外侧区皮肤的血供由足背动脉发出外踝前动脉或跗外侧动脉供应,第一跖背区皮肤的血供由足背动脉-第一跖背动脉的皮支营养,各区域供养血管互有代偿。结论以足背动脉及伴行静脉为血管蒂的足背三叶皮瓣,血供可靠,可用于修复多指皮肤缺损。 Objective: To introduce a simple and effective method for nipple-areola reconstruction. Methods: Modified skate flap was used for nipple-areola reconstruction since May 1998. The technique was performed on 6 breasts in 6 patients. Results: All patients were satisfied with the results. Conclusion: This is a simple and effective method for nipple-areola reconstruction. 目的 :介绍一种简单、有效的乳头乳晕再造的方法。方法 :采用改良三叶皮瓣法对 6例患者行乳头乳晕再造。结果 :6例患者均取得满意的效果 ,无 1例出现坏死。结论 :改良三叶皮瓣法是一种简单有效的乳头乳晕再造方法 ,值得临床推广应用
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