The Deep Inferior Epigastric Artery Free Skin Flap: Experience of Four Cases

深腹壁下動脈皮瓣是由於克服傳統腹直肌肌皮瓣的肥大問題而產生的。於1989年Dr Koshima及Soeda首先提出一塊不帶腹直肌僅經由一條臍肌皮穿通動脈來供應的深腹壁下動脈皮瓣。此外Dr Itoh於1993年更證實了經由切除大量的脂肪組織，它可以是一塊相當簿的皮瓣。我們利用此皮瓣來重建四個患者分別於臉頰，前臂，手腕及足背的缺損，得到兩個完全存活，一個部份邊緣皮瓣壞死，及一個遠位半塊皮瓣壞死的結果。我們選擇此塊大面積的皮瓣基於以下的優點：厚度很小，長及大口徑的血管，術中不須更換患者姿勢，和一個隱藏的腹部供皮疤痕。如同Koshima所提，我們亦經歷了分離深腹壁下動脈之肌皮穿通動脈的困難。然而明顯的此塊深腹壁下動脈皮瓣確實克服了傳統腹直肌肌皮瓣的缺點。

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並列摘要

The deep inferior epigastric artery free skin flap was originated from the conventional rectus abdominis musculocutaneous flap to overcome the problem of bulk. A deep inferior epigastric artery skin flap surviving on a single paraumbilical muscular perforator without rectus abdominis muscle was first reported by Koshima and Soeda in 1989. Moreover, it was proved by Itoh in 1993 that by excising a large volume of subcutaneous fatty tissues, this flap can be extremely thinned. We have used this free skin flap in four of our patients for resurfacing the defects over cheek, forearm, wrist and dorsal foot, with two uneventful, one partial edge necrosis and one distal half flap necrosis results. No postoperative abdominal herniation of donor site was experienced within a follow-up period from six to ten months. We chose this large territory skin flap for its advantages of small thickness, long and large-caliber pedicle, no need of intra-operative reposition and a nonexposed donor scar. As a disadvantage described by Koshima, we also faced the difficulty in dissecting the perforators. Obviously this flap largely overcomes the problems of conventional rectus abdominis musculocutaneous flap.

並列關鍵字

DIEA-deep inferior epigastric artery ； Skin flap

國際替代計量

The Deep Inferior Epigastric Artery Free Skin Flap: Experience of Four Cases

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