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Perforating arteries of the anteromedial aspect of the thigh: an anatomical study regarding anteromedial thigh flap

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Abstract

Purpose

Because the skin of anteromedial thigh region usually is thinner, pliable, hairless it can be preferred based on the requirements of the recipient site. In this way more information is necessary about the perforators of anteromedial thigh region. The aim of this cadaveric study was described to provide useful knowledge about localizations and number of anteromedial thigh perforators.

Methods

Study was carried out on 16 lower extremities of 9 cadavers. The area in anteromedial aspect of the thigh searched for perforators was defined between the anterolateral border of sartorius and the posterior border of gracilis. The diameters of the dissected perforators were measured and the locations were documented.

Results

A total of 204 perforators were dissected in 16 lower extremities. The majority of musculocutaneous perforators were from gracilis (24 of 37) and there were at most 3 musculocutaneous perforators arising from gracilis muscle. 167 septocutaneous perforators were identified. Origin of all perforators was determined as 52 from deep femoral artery, 25 from proximal part of femoral artery and 127 from distal part of femoral artery and their branches. Perforators with the largest diameter were the ones arising from the intermuscular septa between the adductor (longus and magnus) and sartorius muscles. The mean diameter of the perforators was 0.75 ± 0.11 mm and ranged between 0.61 and 0.96 mm.

Conclusions

The septocutaneous perforators of the anteromedial aspect of the thigh are as much important as the musculocutaneous perforators and all they are with adequate to perform anteromedial thigh flap. This study provides numerical overview, useful perception about the localization of the perforators of the anteromedial aspect of the thigh and detailed anatomical basis for anteromedial thigh flap to be an important alternative.

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References

  1. Acland RD, Schusterman M, Godina M, Eder E, Taylor GI, Carlisle I (1981) The saphenous neurovascular free flap. Plast Reconstr Surg 67:763–774

    Article  PubMed  CAS  Google Scholar 

  2. Arnez ZM, Pogorelec D, Planinsek F, Ahcan U (2004) Breast reconstruction by the free transverse gracilis (TUG) flap. Br J Plast Surg 57:20–26

    Article  PubMed  CAS  Google Scholar 

  3. Baek SM (1983) Two new cutaneous free flaps: the medial and lateral thigh flaps. Plast Reconstr Surg 713:354–365

    Article  Google Scholar 

  4. Coquerel-Beghin D, Milliez PY, Auquit-Auckbur I, Lemierre G, Duparc F (2006) The gracilis musculocutaneous flap: vascular supply of the muscle and skin components. Surg Radiol Anat 28:588–595

    Article  PubMed  Google Scholar 

  5. Cormack GC, Lamberty BG (1984) A classification of fascio-cutaneous flaps according to their patterns of vascularisation. Br J Plast Surg 37:80–87

    Article  PubMed  CAS  Google Scholar 

  6. Cormack GC, Lamberty BGH (1986) The arterial anatomy of skin flaps. 1st edn. Churchill-Livingstone, Edinburg

  7. Esser JF (1917) Studies in plastic surgery of the face: I use of skin from the neck to replace face defects. II. Plastic operations about the mouth. III. The epidermic inlay. Ann Surg 65:297–315

    Article  PubMed  CAS  Google Scholar 

  8. Giordano PA, Abbes M, Pequignot JP (1990) Gracilis blood supply: anatomical and clinical re-evaluation. Br J Plast Surg 43:266–272

    Article  PubMed  CAS  Google Scholar 

  9. Haertsch PA (1981) The blood supply to the skin of the leg: a post-mortem investigation. Br J Plast Surg 34:470–477

    Article  PubMed  CAS  Google Scholar 

  10. Hallock GG (2003) The medial circumflex femoral (gracilis) local perforator flap—a local medial groin perforator flap. Ann Plast Surg 51:460–464

    Article  PubMed  Google Scholar 

  11. Hallock GG (2003) The gracilis (medial circumflex femoral) perforator flap: a medial groin free flap? Ann Plast Surg 51:623–626

    Article  PubMed  Google Scholar 

  12. Hallock GG (2004) The conjoint medial circumflex femoral perforator and gracilis muscle free flap. Plast Reconstr Surg 113:339–346

    Article  PubMed  Google Scholar 

  13. Har-Shai Y, Hirshowitz B, Marcovich A, Eliachar I, Peretz BA (1984) Blood supply and innervation of the supermedial thigh flap employed in one-stage reconstruction of the scrotum and vulva—an anatomical study. Ann Plast Surg 13:504–510

    Article  PubMed  CAS  Google Scholar 

  14. Kappler UA, Constantinescu MA, Büchler U, Vögelin E (2005) Anatomy of the proximal cutaneous perforator vessels of the gracilis muscle. Br J Plast Surg 58:445–448

    Article  PubMed  CAS  Google Scholar 

  15. Koshima I, Endou T, Soeda S, Yamasaki M (1988) The free or pedicled saphenous flap. Ann Plast Surg 21:369–374

    Article  PubMed  CAS  Google Scholar 

  16. Karamürsel S, Celebioğlu S (2006) Use of the medial side of the knee skin as a free flap: saphenous flap. Plast Reconstr Surg 117:1308–1314

    Article  PubMed  Google Scholar 

  17. Moscatiello F, Masià J, Carrera A, Clavero JA, Larrañaga JR, Pons G (2007) The ‘propeller’ distal anteromedial thigh perforator flap. Anatomic study and clinical applications. J Plast Reconstr Aesthet Surg 60:1323–1330

    Article  PubMed  Google Scholar 

  18. McCraw JB, Massey FM, Shanklin KD, Horton CE (1976) Vaginal reconstruction with gracilis myocutaneous flaps. Plast Reconstr Surg 58:176–183

    Article  PubMed  CAS  Google Scholar 

  19. Pan WR, Taylor GI (2009) The angiosomes of the thigh and buttock. Plast Reconstr Surg 123:236–249

    Article  PubMed  CAS  Google Scholar 

  20. Peek A, Müller M, Exner K (2002) The free gracilis perforator flap for autologous breast reconstruction. Handchir Mikrochir Plast Chir 34:245–250

    Article  PubMed  CAS  Google Scholar 

  21. Persichetti P, Simone P, Berloco M, Casadei RM, Marangi GF, Cagli B, Di Lella F (2003) Vulvo-perineal reconstruction: medial thigh septo-fascio-cutaneous island flap. Ann Plast Surg 50:85–89

    Article  PubMed  Google Scholar 

  22. Pontén B (1981) The fasciocutaneous flap: its use in soft tissue defects of the lower leg. Br J Plast Surg 34:215–220

    Article  PubMed  Google Scholar 

  23. Salmon M (1936) Arteres de la Peau. Masson et Cie, Paris

    Google Scholar 

  24. Orticochea M (1972) The musculo-cutaneous flap method: an immediate and heroic substitute for the method of delay. Br J Plast Surg 25:106–110

    Article  PubMed  CAS  Google Scholar 

  25. Schoeller T, Huemer GM, Shafighi M, Gurunluoglu R, Wechselberger G, Piza-Katzer H (2004) Free anteromedial thigh flap: clinical application and review of literature. Microsurgery 24:43–48

    Article  PubMed  Google Scholar 

  26. Song YG, Chen GZ, Song YL (1984) The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 37:149–159

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  28. Yousif NJ, Matloub HS, Kolachalam R, Grunert BK, Sanger JR (1992) The transverse gracilis musculocutaneous flap. Ann Plast Surg 29:482–490

    Article  PubMed  CAS  Google Scholar 

  29. Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH (2002) Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 109:2219–2226

    Article  PubMed  Google Scholar 

  30. Wang TN, Whetzel T, Mathes SJ, Vasconez LO (1987) A fasciocutaneous flap for vaginal and perineal reconstruction. Plast Reconstr Surg 80:95–103

    Article  PubMed  CAS  Google Scholar 

  31. Wong CH, Wei FC (2010) Microsurgical free flap in head and neck reconstruction. Head Neck 32:1236–1245

    Google Scholar 

Download references

Conflict of interest

The authors declare that they have not received any financial support and there are no conflicts of interest for the publication of this article.

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Authors and Affiliations

  1. Department of Anatomy, Faculty of Medicine, Ankara University, 06100 Sihhiye, Ankara, Turkey

    Ayhan Cömert & İbrahim Tekdemir

  2. Department of 2nd Plastic and Reconstructive Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey

    Serdar Altun & Ramazan Erkin Ünlü

  3. Department of Plastıc and Reconstructıve Surgery, Nippon Medıcal School, Tokyo, Japan

    Hakan Orbay

Authors
  1. Ayhan Cömert
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  2. Serdar Altun
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  3. Ramazan Erkin Ünlü
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  4. Hakan Orbay
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  5. İbrahim Tekdemir
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Correspondence to Ayhan Cömert.

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Cömert, A., Altun, S., Ünlü, R.E. et al. Perforating arteries of the anteromedial aspect of the thigh: an anatomical study regarding anteromedial thigh flap. Surg Radiol Anat 33, 241–247 (2011). https://doi.org/10.1007/s00276-010-0738-x

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  • DOI: https://doi.org/10.1007/s00276-010-0738-x

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