足背、掌背分裂皮瓣的解剖学基础与临床应用

发布时间：2018-04-22 13:40

本文选题：外科皮瓣 + 皮肤缺损　；参考：《山东大学》2006年硕士论文

【摘要】：研究背景在20世纪50年代之前，皮瓣的设计仍然受到长宽比例的限制，而且主要以带蒂转位的随意皮瓣为主。二十世纪后半叶，随着皮肤血液供应解剖研究的深入及显微外科技术的发展，经过不断的临床探索，外科皮瓣取得了空前的进展。现今，外科皮瓣的应用愈来愈广。随着对生活质量要求的提高，人们对皮瓣临床效果的期望值也愈来愈高；不单要求在受区修复缺损、覆盖外露组织，重建功能，改善外形，而且，在供区亦要减少创伤，保障功能与外形。从而，对皮瓣外科提出了更高的要求，也将之推向了追求“艺术与美”的新阶段。临床上，足背、掌背皮瓣因其皮肤质地佳，弹性好，皮下组织薄以及血管蒂长、有可吻合的神经等优点，，成为最常用的皮瓣之一。传统的掌背、足背皮瓣可以很好的覆盖创面，恢复受区功能及外形，但是供区的处理一直是困扰大家的难题。植皮易坏死，皮瓣修复创伤大、手术难度增加，且需要二次整形。由此，如何更好地处理供区，便成为本课题的中心内容。基于对皮瓣供受区的双重考虑，设计了一种新型的创面覆盖方法——分裂皮瓣。分裂皮瓣是以保障受区良好覆盖及实现供区直接缝合为目的，设计并切取一长条形皮瓣，在其中间选取一合适切口线，切至真皮下，保留皮下组织(浅筋膜)完整，通过恰当扭转改形，将之拼合成所需要形状的皮瓣，用以转位或移植修复创面。这样便可直接缝和供区，避免了供区植皮甚至皮瓣修复而引起的并发症或缺陷。目的 (1) 探讨分裂皮瓣的解剖学基础及掌背、足背解剖学要点。(2)探索分
[Abstract]:Before 1950s, the design of the flap was still limited by the length and width of the flap, and mainly with the free flap with the pedicle transposition. In the second half of twentieth Century, with the development of the anatomy of the skin blood supply anatomy and the development of the microsurgical technique, the surgical flaps have made unprecedented progress.
Nowadays, the application of surgical flaps is becoming more and more widely. With the improvement of the quality of life, the expectation of the clinical effect of the skin flap is also higher and higher. It is not only required to repair the defect in the area, cover the tissue, reconstruct the function, improve the shape, and also reduce the trauma, protect the function and shape in the donor area. Thus, the skin flap surgery is put forward. In clinical, the foot back and the dorsal metacarpal flap are one of the most commonly used flaps, because of their good skin texture, good elasticity, thin subcutaneous tissue, long vascular pedicle, and anastomosable nerve, and the traditional dorsal and dorsal flap of the foot can cover the wound well and restore the area. Function and shape, but the treatment of the donor area has been a difficult problem. Skin grafting is easy to be necrotic, skin flap repair is great, the difficulty of operation is increased, and two times of plastic surgery is needed. Thus, how to better deal with the donor area is the central content of this topic.
Based on the dual consideration of the flap donor area, a new type of wound cover method, split flap, is designed to ensure the good coverage of the recipient area and to realize the direct suture of the donor area. A long strip flap is designed and cut in the middle of the skin flap, and a suitable incision line is selected in the middle of the skin flap, and the subcutaneous tissue (superficial fascia) is kept under the skin. Through proper torsion and modification, the flap is assembled to the required shape of the flap for transposition or transplantation to repair the wound. Thus, the skin flap can be directly sewed and supplied to avoid complications or defects caused by the skin graft or even the skin flap repair.
Objective (1) to investigate the anatomical basis of the split skin flap and the anatomy of the dorsal metacarpal and dorsalis pedis. (2) explore the points.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R622;R322

【相似文献】