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Measurement and analysis of the perforator arteries in upper extremity for the flap design

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Abstract

The aim of this study was to provide the anatomical basis for the skin flap pedicled with the nutrient vessels of the cutaneous nerves and cutaneous veins of the upper extremity. Radio-opaque material was injected into the common carotid arteries of five fresh cadavers. The skin and the fascia were meticulously dissected, removed, and radiographed. The Photoshop CS and Scion image 4.02 were used to analyze the cutaneous arteries, the density of vessels, and the vascular territories of the perforator arteries. The results showed that the cutaneous arteries of the upper extremity came from 16 original arteries, and accordingly, the superficial tissue of the upper extremity could be divided into 16 vascular territories. The external diameter and the area of blood supply of each perforator were growing downwards from the proximum to the distal end. But the points at which the perforator arteries came out from the deep tissue were concentrated near the cutaneous nerves and cutaneous veins, and the arteries formed vascular chains. The density of the arteries near the cutaneous nerves and cutaneous veins was much higher than that of other areas. This article discussed the regularity of the nutrient vessels of the cutaneous nerves and veins on the basis of the experimental results.

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References

  1. Bertelli J, Khoury Z (1991) Vascularization of lateral and medial cutaneous nerves of the forearm Anatomic basis of neuro-cutaneous island flap on the elbow. Surg Radiol Anat 13(4):345–346

    Article  CAS  PubMed  Google Scholar 

  2. Bertelli JA, Khoury Z (1992) Neurocutaneous island flap in the hand: anatomical basis and preliminary results. Br J Plast Surg 45(8):586–590

    Article  CAS  PubMed  Google Scholar 

  3. Masquelet AC, Romana MC, Wolf G (1992) Skin island flap supplied by the vascular axis of the sensitive superficial nerves: anatomic study and clinical experience in the leg. Plast Reconstr Surg 89(6):1115–1121

    Article  CAS  PubMed  Google Scholar 

  4. Nakajima H, Imanishi N, Fukuzumi S et al (1998) Accompanying arteries of the cutaneous veins and cutaneous nerves in the extremities: anatomical study and a concept of the venoadipofascial and/or neuroadipofascial pedicled fasciocutaneous flap. Plast Reconstr Surg 102(3):779–791

    Article  CAS  PubMed  Google Scholar 

  5. Nakajima H, Imanishi N, Fukuzumi S et al (1999) Accompanying arteries of the lesser saphenous vein and sural nerve: anatomical study and its clinic applications. Plast Reconstr Surg 103(1):104–120

    Article  CAS  PubMed  Google Scholar 

  6. Wang S, Luo S, Hao X (2000) The superficial vein, cutaneous nerve and its nutrient vessels in the forearm: anatomic study and the clinical implication. Zhonghua Zheng Xing Wai Ke Za Zhi 16(4):212–215

    CAS  PubMed  Google Scholar 

  7. Bertelli JA, Pereira Filho OJ, Ely JB (1999) Sensitive areolar reconstruction in using a neurocutaneous island flap based on the medial antebrachial cutaneous nerve. Plast Reconstr Surg 104(6):1748–1750

    Article  CAS  PubMed  Google Scholar 

  8. Rui YJ, Shou KSH, Xu JG et al (1998) Clinical application of the neurocutaneous concomitant vessel pedicled island flap to repair of hand soft tissue defect. Chin J Hand Surg 14(2):70–71

    Google Scholar 

  9. Hong MK, Hong MK, Taylor GI (2006) Angiosome territories of the nerves of the upper limbs. Plast Reconstr Surg 118(1):148–160

    Article  CAS  PubMed  Google Scholar 

  10. Hwang K, Lee WJ, Jung CY et al (2005) Cutaneous perforators of the upper arm and clinical applications. J Reconstr Microsurg 21(7):463–469

    Article  PubMed  Google Scholar 

  11. Inoue Y, Taylor GI (1996) The angiosomes of the forearm: anatomic study and clinical implications. Plast Reconstr Surg 98(2):195–210

    Article  CAS  PubMed  Google Scholar 

  12. Taylor GI (2003) The angiosomes of the body and their supply to perforator flaps. Clin Plast Surg 30(3):331–342

    Article  PubMed  Google Scholar 

  13. Taylor GI, Palmer JH (1987) The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg 40(2):113–141

    Article  CAS  PubMed  Google Scholar 

  14. Tang ML, Geddes CR, Yang DP et al (2002) Modified lead oxide-gelatin injection technique for vascular studies. J Clin Anat 1(1):73–78

    Google Scholar 

  15. Taylor GI, Gianoutsos MP, Morris SF (1994) The neurovascular territories of the skin and muscles: anatomic study and clinical implications. Plast Reconstr Surg 94(1):1–36

    Article  CAS  PubMed  Google Scholar 

  16. Taylor GI, Minabe T (1992) The angiosomes of the mammals and other vertebrates. Plast Reconstr Surg 89(2):181–215

    Article  CAS  PubMed  Google Scholar 

  17. Kang A, Xiong MG, Gu H et al (2001) Clinical application of reverse-flow flaps pedicled with superficial venous trunks. Chin J Aesthet Med 10(5):370–372

    Google Scholar 

  18. Noreldin AA, Fukuta K, Jackson IT (1992) Role of perivenous areolar tissue in the viability of venous flaps: an experimental study on the inferior epigastric venous flap of the rat. Br J Plast Surg 45(1):18–22

    Article  CAS  PubMed  Google Scholar 

  19. Imanishi N, Nakajima H, Aiso S (1996) A radiographic perfusion study of the cephalic venous flap. Plast Reconstr Surg 97(2):408–412

    Article  CAS  PubMed  Google Scholar 

  20. Zhang SM, Hou CL, Xu DC (2001) Revaluation to the skin flap with the nutrient vessels of the cutaneous nerve. Chin J Clin Anat 19(1):82–83

    Google Scholar 

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Acknowledgments

This study was supported by Hunan Provincial Natural Science Foundation of China (07JJ6161), and we would like to thank Madam Mei-mei Chen for checking the paper.

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Correspondence to Da-chuan Xu.

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Chen, Sh., Xu, Dc., Tang, Ml. et al. Measurement and analysis of the perforator arteries in upper extremity for the flap design. Surg Radiol Anat 31, 687–693 (2009). https://doi.org/10.1007/s00276-009-0505-z

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  • DOI: https://doi.org/10.1007/s00276-009-0505-z

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