Portenard Anne-Carole, Auquit-Auckbur Isabelle, Gardeil Ludivine, Elbaz Bénédicte, Carricaburu Alice, Duparc Fabrice
Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, 1 rue de Germont, 76031, Rouen, France.
Department of Orthopedic Surgery, Rouen University Hospital, 1 rue de Germont, 76031, Rouen, France.
Surg Radiol Anat. 2019 Nov;41(11):1361-1367. doi: 10.1007/s00276-019-02322-8. Epub 2019 Sep 6.
The aim of this anatomical study was to describe a local perforator flap, for covering shoulder defects, by determining the features of the acromial branch of the thoraco-acromial artery (abTAA), and the supplied cutaneous area.
Thirteen fresh cadaveric thoraxes were dissected bilaterally. A precise and reproducible protocol was performed. For each abTAA flap cadaveric dissection, the following parameters were measured after arterial injection: distances between the origin of the perforator artery on the abTAA and the sternum, the acromion, the clavicle, diameter of the perforator artery of the abTAA, length of the perforator pedicle course through major pectoralis muscle, and rotation arc. We also calculated the surface of the injected skin paddle. These measurements were related to morphometric parameters evaluated through the distance between sternum and acromion.
The mean distances measured from the origin of the perforator artery on the abTAA were 14.25 cm to the sternum, 3.45 cm to the acromion, 5.65 cm to the clavicle. The mean diameter of the abTAA was 1.20 mm ± 0.2. The arc of rotation was 180°, and the length of the perforator pedicle could be extended to 7.46 cm ± 1.15. We observed an colored elliptical cutaneous paddle with a longer radius 18 cm and a small radius 15 cm.
Our results suggest that this type of flap could be useful in clinical practice for reconstruction and covering of the acromial area with a thin cutaneous flap with low sequelae on the donor site.
本解剖学研究的目的是通过确定胸肩峰动脉肩峰支（abTAA）的特征及其供血的皮肤区域，描述一种用于覆盖肩部缺损的局部穿支皮瓣。
对13具新鲜尸体胸部进行双侧解剖。执行了精确且可重复的方案。对于每个abTAA皮瓣尸体解剖，在动脉注射后测量以下参数：穿支动脉在abTAA上的起源与胸骨、肩峰、锁骨之间的距离，abTAA穿支动脉的直径，穿支蒂穿过胸大肌的长度以及旋转弧。我们还计算了注射皮肤瓣的表面积。这些测量值与通过胸骨和肩峰之间的距离评估的形态学参数相关。
从abTAA上穿支动脉的起源测量的平均距离分别为：距胸骨14.25厘米，距肩峰3.45厘米，距锁骨5.65厘米。abTAA的平均直径为1.20毫米±0.2。旋转弧为180°，穿支蒂的长度可延长至7.46厘米±1.15。我们观察到一个彩色椭圆形皮肤瓣，长半径为18厘米，短半径为15厘米。
我们的结果表明，这种类型的皮瓣在临床实践中可能有助于用供区后遗症少的薄皮瓣重建和覆盖肩峰区域。
