More potential uses of specific perforator flaps in the calf – A cadaveric study on the subdermal vascular structure of the lower leg

IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Annals of Anatomy-Anatomischer Anzeiger Pub Date : 2024-04-04 DOI:10.1016/j.aanat.2024.152262
Xin Wang , Zao-Peng He , Ye Sun , Liang-Chang Li , Yan-Qun Liu , Yi-Ran Yang , Ling-Na Qi , Jing-Han Yang , Yu-Tong Shi , Xiang-Zheng Qin
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Abstract

Background

The perforator flap has garnered significant interest since its inception due to its advantage of not needing a vascular network at the deep fascial level. Perforator flaps are commonly utilized in different flap transplant surgeries, and the thigh flap is presently the most widely used perforator flap. Is it possible for the calf to replace the thigh as a more suitable site for harvesting materials? Currently, there is a lack of relevant anatomical research. This study aims to address this question from an anatomical and imaging perspective.

Methods

This study used cadavers to observe the branches and courses of perforators on the calf and the distribution of skin branches using microdissection techniques, digital X-ray photography, and micro-computed tomography techniques.

Results

The perforators had three main branches: the vertical cutaneous branch, the oblique cutaneous branch, and the superficial fascial branch. The superficial fascial branch traveled in the superficial fascia and connected with the nearby perforators. The vertical and oblique cutaneous branches entered the subdermal layer and connected with each other to create the subdermal vascular network.

Conclusions

We observed an intact calf cutaneous branch chain between the cutaneous nerve and the perforator of the infrapopliteal main artery at the superficial vein site. Utilizing this anatomical structure, the calfskin branch has the potential to serve as a substitute for thigh skin flap transplantation and may be applied to perforator flap transplantation in more locations.

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小腿特定穿孔器皮瓣的更多潜在用途 - 小腿皮下血管结构的尸体研究
背景穿孔器皮瓣因其无需深筋膜层血管网络的优势,自诞生以来就备受关注。穿孔器皮瓣常用于不同的皮瓣移植手术,而大腿皮瓣是目前使用最广泛的穿孔器皮瓣。小腿是否有可能取代大腿,成为更适合采集材料的部位?目前还缺乏相关的解剖学研究。本研究旨在从解剖学和影像学角度解决这一问题。研究方法本研究使用尸体,通过显微解剖技术、数字 X 光摄影和显微计算机断层扫描技术观察穿孔器在小腿上的分支和走向,以及皮肤分支的分布情况。结果穿孔器有三个主要分支:垂直皮支、斜皮支和浅筋膜支。浅筋膜支在浅筋膜内游走,并与附近的穿孔器相连。结论我们观察到在浅静脉部位的皮神经和膝下主动脉穿孔器之间有一条完整的小腿皮神经分支链。利用这一解剖结构,小腿皮支有可能替代大腿皮瓣移植,并可应用于更多部位的穿孔器皮瓣移植。
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来源期刊
Annals of Anatomy-Anatomischer Anzeiger
Annals of Anatomy-Anatomischer Anzeiger 医学-解剖学与形态学
CiteScore
4.40
自引率
22.70%
发文量
137
审稿时长
33 days
期刊介绍: Annals of Anatomy publish peer reviewed original articles as well as brief review articles. The journal is open to original papers covering a link between anatomy and areas such as •molecular biology, •cell biology •reproductive biology •immunobiology •developmental biology, neurobiology •embryology as well as •neuroanatomy •neuroimmunology •clinical anatomy •comparative anatomy •modern imaging techniques •evolution, and especially also •aging
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