Extending anatomical basis of pedicled gracilis musculocutaneous flaps in perineal reconstruction
10.3760/cma.j.cn114453-20200214-00044
- VernacularTitle:带蒂股薄肌肌皮瓣在会阴缺损修复中的延展解剖研究
- Author:
Li WANG
1
;
Dajiang SONG
;
Zan LI
;
Keqiang ZHANG
;
Yixin ZHANG
;
Xiaowei PENG
;
Guang FENG
;
Bo ZHOU
;
Chunliu LYU
;
Peng WU
;
Yuanyuan TANG
;
Liang YI
;
Zhenhua LUO
Author Information
1. 常德市第一人民医院妇产科 415000
- Keywords:
Myocutaneous flap;
Vulvar neoplasms;
Perineum, reconstructive surgical procedures;
Gracilis musculocutaneous flap
- From:
Chinese Journal of Plastic Surgery
2020;36(12):1375-1379
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the extending design and anatomical basis of pedicled gracilis musculocutaneous flaps in perineal reconstruction.Methods:On six female cadavers (age ranged from 27 to 52 years old, 41.2 on average), bilateral gracilis flaps were designed, raised and transferred in the standard surgical manner and tunneled under the adductor longus muscle. Measured the distance from the tip of 12 flaps to the bilateral anterior superior iliac spine (ASIS). The myocutaneous flaps were then transferred and the distances from the tip of flaps to the ASIS were measured again. The paired sample t test (double tail) was used to compare the data measured by the two transfer method.Results:Cadaveric dissection revealed that in 6 corpses, bilateral profunda artery muscular branches all courses between the longus adductor and mangus adductor muscles, the pedicle length of 12 gracilis musculocutaneous flaps was(7.84±0.71) cm. In the standard surgical manner group, after transferring, the distance from the tip of flaps to the ipsilateral ASIS was (9.23±0.95) cm, ranged from 6.9 cm to 10.5 cm, the distance from the tip of flaps to the contralateral ASIS was(11.45±2.27) cm, ranged from 7.5 cm to 14.8 cm. In the tunnelled under the adductor longus muscle extension design group, after transferring, the distance from the tip of flaps to the ipsilateral ASIS was (4.52±1.18) cm, ranged from 2.7 cm to 6.5 cm, the distance from the tip of flaps to the contralateral ASIS was (8.92 ±1.82) cm, ranged from 4.8 cm to 11.7 cm. Compared with the standard surgical manner group, tunneling the flap under the adductor longus muscle to the ipsilateral side increased the reach by 3.5 cm to 7.3 cm, (4.71±1.14) cm, to contralateral side increased the reach by 0.9 cm to 4.1 cm, (2.53±0.89) cm. The distance to the ipsilateral anterior superior iliac spine measured by the two method , t=13.194, P<0.001, and the distance to the contralateral anterior superior iliac spine, t=9.057, P<0.001. The difference was statistically significant. The tunneled under the adductor longus muscle extension design group can increase the reach of reconstructive scope by 3.62 cm on average. The additional increasing length of tunneled under the adductor longus muscle method is 46.2%(3.62/7.84) of the average vascular pedicle length. Conclusions:Cadaveric dissection result have shown that tunneling of the gracilis musculocutaneous flap in a novel extension design way can enlengthen the pedicle length, increase its reach across the perineum.
