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目的:探索数字技术模拟皮瓣供血结构的变化对皮瓣皮肤血供的影响,为薄型股前外侧皮瓣中的应用提供数字解剖学依据。方法:6侧动脉灌注氧化铅-明胶的新鲜成人下肢标本,显微解剖观察股前外侧区皮肤穿支血管的走行、结构,在去脂肪修薄皮肤的过程中,分步拍摄X线片并行螺旋CT连续扫描,观察、分析皮肤血管结构。分别对保留和破坏筋膜支的标本行螺旋CT连续扫描,同时应用计算机软件分别对源于旋股外侧动脉的各条皮穿支进行血管三维重建。结果:三维重建的数字化模型可准确反映皮瓣筋膜丛及真皮下血管丛的基本情况,可准确直观模拟皮瓣修薄前后各皮穿支的基本供血结构;三维重建的数字化模型与显微解剖、X线片观察结果一致。结论:数字化模拟技术能够客观模拟各皮穿支在皮瓣修薄前后供血区域的变化;缺乏筋膜丛的区域,真皮下血管丛较发达,皮瓣修薄后,其皮肤血供不受影响。
Objective: To explore the digital technique to simulate the influence of the change of blood supply structure on the blood supply of skin flap, and to provide digital anatomy basis for the application of thin anterolateral skin flap. Methods: Fresh adult lower extremity specimens of lead oxide-gelatin were perfused with 6 arteries. Micro-dissection was used to observe the movement and structure of the perforator blood vessels in the anterolateral femoral region. In the course of defatting the skin, the radiographs were taken in parallel Continuous spiral CT scan, observation, analysis of skin vascular structure. The specimens of fascia of the fascia were preserved and destructed by spiral CT scan. At the same time, computer software was used to reconstruct the blood vessels of the percutaneous branches of the circumflex femoral artery. Results: The digital model of three-dimensional reconstruction can accurately reflect the basic situation of flap fascia and subdermal vascular bundle, accurately and directly simulate the basic blood supply structure of percutaneous branches before and after skin flap thinning. The digital model of three-dimensional reconstruction and microscopic Anatomy, X-ray observations were consistent. Conclusion: The digital simulation technique can objectively simulate the changes of blood supply area before and after skin flap prostheses. In the area lacking fascia, the subdermal vascular plexus is more developed. After skin flap is thinned, the skin blood supply is not affected .