Anatomical study of the vascularization of the pedicled osteo-myo-cutaneous scapulo-dorsal flap.

PURPOSE

The main objective of this study was to conduct a radioanatomical study of the osteo-myo-cutaneous scapulo-dorsal pedicled flap.

METHODS

A radiological study was performed to study the anatomical variations of the dorsal scapular pedicle (origin, course of the deep branch of the dorsal scapular artery (DSA) in relation to the medial border of the scapula, perforators from the superficial branch of the DSA). Perforators from the superficial branch of the DSA were also identified on anatomical subjects, and their cutaneous vascular territory was determined.

RESULTS

The DSA originated from the transverse cervical artery in 95% of cases. The deep branch of the DSA was in an anterolateral position relative to the medial border of the scapula in 70% of cases, and in an anteromedial position in 30%. In most cases, between 1 and 2 perforators arised from the superficial branch of the DSA. The mean size of the cutaneous vascular territory arising from the perforators of the superficial branch of the DSA was 7.8cmx8.5 cm.

CONCLUSION

When mandibular reconstruction with this flap is considered, a preoperative CT angiogram could ensure that the transverse cervical vessels have been preserved, and determine the position of the deep branch of the DSA relative to the medial edge of the scapula.