A cadaveric study of meticulous vascular network in the skin flaps by injection with a Microfil via perforator

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K16989
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56070:Plastic and reconstructive surgery-related
• Research Institution: The University of Tokushima
• Principal Investigator: ABE Yoshiro 徳島大学, 大学院医歯薬学研究部(医学域), 准教授 (40467808)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 血管解剖 / 皮膚穿通枝 / 前外側大腿皮弁 / perforazome / angiozome / linking vessel

Outline of Final Research Achievements

In order to elucidate the perforazome between the perforation branches of the anterolateral thigh flap, blood vessels were visualized using Microfil contrast agent on a total of 4 fresh cadavers. It was confirmed that the perforators greater than 1 mm in width, in which attached to the fascia lata, were stained up to the adipose tissue corresponding to the peripheral perfusion area, but the staining of the contrast agent could not be confirmed in the penetrating branches smaller than 1 mm. Furthermore, it was found that the area to be stained differs depending on the position of the penetrating branch into which Microfil was injected. It was found that the stained area spread behind the thigh in case that proximal perforators were used.

Free Research Field

形成外科学

Academic Significance and Societal Importance of the Research Achievements

癌や事故などによる組織欠損に対し、形成外科領域では身体各所にさまざまな皮弁を作成し、これらの欠損を充填・被覆している。特に遊離皮弁術と呼ばれる遠隔からの組織移植手術の安全性と汎用性を高めることは、癌切除に伴う広範囲再建手術後の合併症率を低下させ、入院期間の短縮や医療費の抑制に大きく寄与するものと思われる。
頭頸部および四肢の再建において代表的な遊離皮弁の一つである前外側大腿皮弁について、本研究は今まで不明瞭であった脂肪内の血行領域を解明したことにより、本皮弁手術手技を安全に完遂する上で実践的かつ重要な知見が得られたと考えられる。