Đang chuẩn bị liên kết để tải về tài liệu:
Practical Plastic Surgery - part 2

chủ yếu vào việc cung cấp máu da từ đám rối bì dưới da. Nắp Pedicled hoặc trục được dựa trên các mạch máu giải phẫu ánh xạ hoặc đặt tên. Nắp Fasciocutaneous đã được phân loại thành ba loại dựa trên các mẫu mạch máu của họ. Loại A: B trực tiếp da Loại pedicle: Septocutaneous pedicle Loại C: | Principles of Surgical Flaps 51 primarily on the cutaneous blood supply from the dermal-subdermal plexus. Pedicled or axial flaps are based on anatomically mapped or named blood vessels. Fasciocutaneous flaps have been classified into three categories based on their vascular patterns. Type A Direct cutaneous pedicle Type B Septocutaneous pedicle Type C Musculocutaneous pedicle Muscle flaps may be classified in two different ways. First Mathes and Nahai developed a system of muscle classification based on circulatory patterns. Type I Single pedicle e.g. tensor fascia lata Type II Dominant pedicle s with minor pedicle s e.g. gracilis Type III Dual dominant pedicles e.g. gluteus maximus Type IV Segmental pedicle s e.g. sartorius Type V Dominant pedicle with secondary segmental pedicle s e.g. latissimus dorsi Second Taylor developed a system of muscle classification based on mode of innervation. Type I Single unbranched nerve enters muscle e.g. latissimus dorsi Type II Single nerve branches prior to entering muscle e.g. vastus lateralis Type III Multiple branches from the same nerve trunk e.g. sartorius Type IV Multiple branches from different nerve trunks e.g. rectus abdominis Finally the body can be further segregated anatomically into three-dimensional vascular territories called angiosomes. The angiosome is a composite unit of skin and underlying deep tissue that is supplied by a source artery. Each angiosome defines an anatomic unit of tissue from skin to bone that may be safely transferred as a composite flap. The angiosomes are interconnected by either true anastomotic arteries in which there is no change in caliber between the vessels of adjacent angiosomes or reduced-caliber choke anastomotic vessels. The junctional zone between adjacent angiosomes usually occurs within the muscles of the deep tissues rather than between them so that most muscles span across two or more angiosomes. Thus when designing musculocutaneous flaps it is possible to capture the skin .