Fasciocutaneous vessels in the upper arm: application to the design of new fasciocutaneous flaps.

The principles of the blood supply to the upper arm are described. Despite the large, fleshy nature of the biceps and the triceps, the blood supply to upper arm skin is not from the underlying muscles, but is by fasciocutaneous perforators emerging along the medial and lateral intermuscular septa. Fifty dissections of preserved cadavers have shown that on the lateral side the fasciocutaneous perforators consistently arise from the middle collateral artery. The available length of this vessel and its diameter have been measured and are reported. The design of a flap based on this vessel, in a manner analogous to the Chinese forearm flap on the radial artery, is described.