Grabs Detlev, Faghahati Shahla, Lampron Audrey, Sobczak Stéphane, Maranzano Josefina, Nayouf Anna
Department of anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; Research Unit in Clinical and Functional Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.
Department of plastic surgery, Hôpital Nord-Ouest, Villefranche sur Saône, France.
J Plast Reconstr Aesthet Surg. 2021 Sep;74(9):1999-2004. doi: 10.1016/j.bjps.2020.12.082. Epub 2021 Jan 9.
The thigh region is a well-known area for harvesting cutaneous flaps for microsurgery replacement, given the characteristics of the skin: thin, flexible, and glabrous. We investigated the vascular pattern of 32 cadaveric anteroproximal thighs for the possibility of an extended harvesting area, which we call the proximal femoral artery perforator region.
We injected colored, radio opaque latex in the external iliac artery and investigated the perforator branches from the superficial circumflex iliac, femoral common, superficial, and deep femoral (profunda femoris) arteries to the skin of the proximal femoral artery perforator region. This region was divided into 3 equal subregions (superior, medial, and lateral), and their perforators were counted and measured.
There was no significant difference in the number of arterial pedicles across the three subregions: 30 superior, 35 inferolateral, and 27 inferomedial. The perforators had a cutaneous path in 81% of the cases, while 6% were musculocutaneous and 5% septocutaneous, without a significant difference in their proportion in the three subregions. The mean length and diameter of the pedicles were 5.39 ± 2.1 cm and 1.07 ± 0.4 mm, respectively, without significant differences in the three subregions.
The proximal femoral artery perforator region is a suitable area to generate flaps of various sizes and shapes, as needed by the surgeon. All perforators were constant and possessed a sufficient diameter and length for a successful anastomosis during the surgical procedure. The donor site retains all technical advantages to successfully replace areas of glabrous skin.
鉴于大腿区域皮肤具有薄、柔韧且无毛的特点,该区域是显微外科手术中用于获取皮瓣进行替代的知名部位。我们研究了32具尸体大腿前近端的血管模式,以探讨扩大切取区域(我们称之为股动脉近端穿支区域)的可能性。
我们将有色、不透射线的乳胶注入髂外动脉,并研究从髂浅动脉、股总动脉、股浅动脉和股深动脉到股动脉近端穿支区域皮肤的穿支分支。该区域被分为3个相等的子区域(上、中、外侧),并对其穿支进行计数和测量。
三个子区域的动脉蒂数量无显著差异:上区30个,下外侧区35个,下内侧区27个。81%的穿支走行于皮下,6%为肌皮穿支,5%为隔皮穿支,其在三个子区域的比例无显著差异。蒂的平均长度和直径分别为5.39±2.1厘米和1.07±0.4毫米,在三个子区域无显著差异。
股动脉近端穿支区域是一个适合根据外科医生需要生成各种大小和形状皮瓣的区域。所有穿支恒定,且在手术过程中具有足够的直径和长度以成功进行吻合。供区保留了成功替代无毛皮肤区域的所有技术优势。