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目的总结面动脉穿支皮瓣(facial artery perforator flap,FAPF)解剖及临床应用研究现状及进展。方法广泛查阅国内外FAPF解剖研究和临床应用的相关文献,并进行整理、分析和总结。结果面动脉穿支(facial artery perforator,FAP)解剖位置较恒定,其中口角附近面动脉发出的穿支最多,每支FAP均有2支静脉与其伴行。FAPF分为蒂位于下颌缘上、下两种,主要用于中面部缺损的修复;下颌缘以上以面动脉主干穿支皮瓣应用最多,内眦动脉穿支皮瓣及鼻旁动脉穿支皮瓣也逐渐得到推广;下颌缘以下以颏下动脉穿支皮瓣应用最广泛。在临床中,面动脉主干及其分支穿支皮瓣的应用都能获得良好的术区功能和面部外观效果。结论FAPF已成为修复口周和鼻翼等缺损的首选皮瓣,具有成活率高、设计灵活、质地薄、与面部其他部位质地及颜色相近、手术操作相对简便等优点。皮瓣制备中关于保留血管蒂周围组织对于皮瓣静脉回流的影响尚需进一步研究。
Objective To summarize the status quo and progress of anatomy and clinical application of facial artery perforator flap (FAPF). Methods Extensive access to the domestic and foreign FAPF anatomy and clinical application of relevant literature, and to organize, analyze and summarize. Results The anatomical location of facial artery perforator (FAP) was relatively constant with the largest number of perforating branches near the facial artery, with 2 veins per each FAP. FAPF is divided into pedicle located in the lower edge of the mandible, the next two, mainly for the repair of facial defects; mandibular margin above the surface of the main artery perforating branch flap is most commonly used, the infranullary artery perforator flap and the nasal branch artery perforator skin Flap has also been gradually promoted; submandibular margin below the submental artery perforating flap is the most widely used. In clinical practice, the application of facial artery and its branches through the flaps can achieve good regional function and facial appearance. Conclusion FAPF has become the preferred flap for repairing the periorbital and nasal defects. It has the advantages of high survival rate, flexible design, thin texture, similar texture and color to other parts of the face, and relatively simple operation. Flap preparation for the preservation of the vascular pedicle on the flap venous return needs further study.