侯春林教授主题带血管蒂的组织瓣移位术解剖与设计原课件.ppt

1、 direct cutaneous arterymusculocutaneous arteryBlood supply of muscleVascular plexus up-fasciaVascular plexus sub-fasciaFasciaSkinMuscleRamus of musculocutaneous arteryVessel between musclesClassification of skin flaps 随意皮瓣随意皮瓣 Random flap 筋膜皮瓣与筋膜瓣筋膜皮瓣与筋膜瓣 Fasciocutaneous flap and fascia flap 轴形皮瓣轴形

2、皮瓣 Axial flap 肌皮瓣与肌瓣肌皮瓣与肌瓣 musculocutaneous flap and muscle flap筋筋 膜膜 皮皮 瓣瓣 SkinSubcutaneus tissuemusclefascia profunda翻翻 转转 筋筋 膜膜 瓣瓣轴轴 型型 皮皮 瓣瓣Vessel between musclesSkinSubcutaneus tissuefascia profundamuscleAxial flap肌肌 皮皮 瓣瓣Musculocutaneous flapMusculocutaneous flap with musculocutaneous pedicleM

3、usculocutaneous flap with musculosubcutaneous pedicle Musculocutaneous flap with muscle pedicle Musculocutaneous island flap with vasonerval pediclemusculocutaneous flapDesign of the flapPointaxis to transfer flapsLine axal line of the flapRangeextent to which the nutritional vessel can supplyArcbou

4、ndary that the flap can reachAxis and arc of flapv 创伤、溃疡、肿瘤切除所致软组织缺损创伤、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 methodsv 四肢瘢痕挛缩畸形，切除瘢痕、矫正畸形四肢瘢痕挛缩畸形，切除瘢痕、矫正畸形有深部组织裸露有深部组织裸露 Malformation caused by scar crispation,bare deep tissues caused by s

5、car excision and malformation rectificationIndicationv需在瘢痕或窦道区进行骨、关节、需在瘢痕或窦道区进行骨、关节、肌腱手术者肌腱手术者 Operations on bone,joint or tendons in regions of scars and sinuses v慢性骨髓炎病灶清除后有创面裸露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 a

6、fter thorough treatment.v感觉、运动功能重建及某些器官再造感觉、运动功能重建及某些器官再造 Wounds repair with simultaneous reconstruction of motor or nerve function.Indicationv对供区功能、外观影响较小对供区功能、外观影响较小 The flap with less affect to donor site.v血管恒定、变异少，易于切取血管恒定、变异少，易于切取 The flap acquired easily and with less variable vessles v根据受区部位、

7、大小、创面性质及根据受区部位、大小、创面性质及 功能要求选择皮瓣功能要求选择皮瓣 The flap suit for recipient site in position,size,quality and function.Selection of flapv邻近创面的皮瓣，质地近似，转邻近创面的皮瓣，质地近似，转移方便，应优先选用移方便，应优先选用 The preferable flap with the character of adjacent to the recipient site,having similar texture and thickness and easily tr

8、ansferredSelection of flap according to recipient sitePlantar flap of foot Dorsal flap of foot Crural flapcalcaneal defectv无骨和肌肉缺损的创面，选用轴型皮瓣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 musclev有骨或肌肉缺损的创面选用肌皮瓣较好有骨或肌肉缺损的创面选用肌皮瓣较好 The musculocutaneous flap suitable for

9、wound with defect of bone and muscleSelection of flap according to defect character v需同时恢复缺损区感觉功能时，应需同时恢复缺损区感觉功能时，应选用含感觉神经的皮瓣；需同时重选用含感觉神经的皮瓣；需同时重建缺损区肌肉功能时，应选用带运建缺损区肌肉功能时，应选用带运动神经的肌皮瓣。动神经的肌皮瓣。If the function of movement or sense is required,the flap should be composed with the muscle or sense nerve.S

10、election of flap according to function requirement of recipient siteSelection of flap according to the size of defectThe size of defect and flap should be considered.The size of flap should exceed that of the defect.手手 术术 要要 点点 Operation outlinev慢性感染创面需彻底病灶清除慢性感染创面需彻底病灶清除 The sinus,dead bone,inflamm

11、atory tissue with poor blood supply must be thoroughly cleaned up.Preparation of the recipient site v先标明旋转中心位置及皮瓣纵先标明旋转中心位置及皮瓣纵轴线，根据创面形状及大小设轴线，根据创面形状及大小设计皮瓣计皮瓣 First,make sure the position of the vascular pedicle and the nutritional vessel of the flap,then mark it on the skin.Design the flap accordi

12、ng to the shape and size of the defect.皮瓣设计皮瓣设计 Design of the flap Repair the sacrum bedsore using the myocutaneous superior of Muscle gluteus maximusv顺行切取顺行切取 先显露血管蒂部先显露血管蒂部,由近向远分离皮瓣由近向远分离皮瓣 First,expose the vascular pedicle,and then cut off the flap along the boundary of the flap.v逆行切取逆行切取 从皮瓣远端开始

13、从皮瓣远端开始,由远向近切取皮瓣由远向近切取皮瓣 First,cut off the flap,and then dissociate the vascular pedicle.皮瓣切取皮瓣切取 operation mannersClassical mannerReverse mannerClassical mannerReverse mannerv皮瓣移位皮瓣移位 Shiftv皮瓣推进皮瓣推进 Advancementv皮瓣旋转皮瓣旋转 Rotationv交叉移植交叉移植 crossing皮瓣转移皮瓣转移 Flap transfer皮皮 瓣瓣 移移 位位Shift of flap皮皮 瓣瓣 推

14、推 进进Advancement of flap皮皮 瓣瓣 旋旋 转转Rotation of flap交交 叉叉 移移 植植Cross transplant Notes Choose the normal skin and muscle as donor tissue.The sinus,dead bone,inflammatory tissue with poor blood supply must be thoroughly cleaned.Cut the flap according to the anatomical arrangement to avoid vessel separat

15、ion from the flap,and muscle from the skin.Notes If the myocutaneous flap is needed,and the skin scope exceeds that of the muscle,the fascia profunda should be reserved completely.During the operation,vascular pedicle should not be curled,pressed and retorted.谢谢大家谢谢大家Thank You!Thank You!后面内容直接删除就行资料可以编辑修改使用资料可以编辑修改使用资料仅供参考，实际情况实际分析主要经营：课件设计，文档制作，网络软件设计、图文设计制作、发布广告等秉着以优质的服务对待每一位客户，做到让客户满意！致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划案、学习课件、各类模板等方方面面，打造全网一站式需求The user can demonstrate on a projector or computer,or print the presentation and make it into a film to be used in a wider field