Rome, Italy; Kaoshiung, Taiwan; and Antalya, Turkey From the Department of Surgery "P Valdoni," Unit of Plastic and Reconstructive Surgery, "Sapienza" University; Department of Plastic and Reconstructive Surgery, E-Da Hospital/I-Shou University; and the Institute of Plastic, Reconstructive, and Aesthetic Surgery, Akdeniz University.
Plast Reconstr Surg. 2014 Feb;133(2):420-429. doi: 10.1097/01.prs.0000437258.85951.a1.
Perforator flaps have become the choice of most reconstructive surgeons because they have decreased donor-site morbidity. Among these flaps, the free anteromedial thigh flap has not yet become a first-choice flap because of the inconstant anatomy of its pedicle. This study aimed to describe the anatomy from different perspectives to highlight common patterns and simplify the flap's application in clinical cases.
The study started in 2004 and took 9 years to complete. It was performed on 12 clinical anteromedial thigh flap cases, 48 clinical cases of anterolateral thigh flap in which the vascular anatomy of the anteromedial thigh flap was studied, and 48 cadaver dissections.
In "type of perforators," the authors found an almost total consistency between clinical cases (group 1) and dissections in patients (group 2) (χ = 0.164 and p = 0.92), whereas the cadaver dissections (group 3) were minimally homogeneous (χ = 13.7 and p = 0.0082). Then, taking into account the parameter "origin of perforators," they noticed the same trend with a clear alignment between the first two groups (χ = 1.84 and p = 0.87) and a strong inhomogeneity in relation to the third group (χ = 19.8 and p = 0.03).
Anatomical study of the anteromedial thigh flap pedicle showed a marked variability that makes preoperative planning difficult, and thus more stressful to realize. This evidence confirms that the flap can be used as a second choice or simultaneously with the anterolateral thigh flap. In addition, the authors strongly suggest a preoperative radiological study to minimize the possible anatomical variabilities during surgery.
穿支皮瓣因其降低了供区的发病率而成为大多数重建外科医生的首选。在这些皮瓣中，游离股前内侧皮瓣由于其蒂部解剖结构的不恒定，尚未成为首选皮瓣。本研究旨在从不同角度描述解剖结构，突出常见模式，并简化皮瓣在临床病例中的应用。
本研究始于 2004 年，历时 9 年完成。共对 12 例临床股前内侧皮瓣病例、48 例研究股前外侧皮瓣血管解剖结构的临床股前外侧皮瓣病例和 48 例尸体解剖进行了研究。
在“穿支类型”方面，作者发现临床病例（第 1 组）和患者尸体解剖（第 2 组）之间几乎完全一致（χ=0.164，p=0.92），而尸体解剖（第 3 组）则存在最小的一致性（χ=13.7，p=0.0082）。然后，考虑到“穿支起源”参数，他们注意到了相同的趋势，前两组之间存在明显的一致性（χ=1.84，p=0.87），而与第 3 组之间存在强烈的不一致性（χ=19.8，p=0.03）。
股前内侧皮瓣蒂部的解剖研究显示出明显的变异性，这使得术前计划变得困难，从而增加了手术的压力。这一证据证实，该皮瓣可以作为第二选择或与股前外侧皮瓣同时使用。此外，作者强烈建议进行术前影像学研究，以最大限度地减少手术中可能存在的解剖变异性。
