Thinning of the Medial Sural Artery Perforator Flap: The Anatomical Examination of the Medial Sural Artery Perforator Branch.

IF 1.5 Q3 SURGERY
Plastic and Reconstructive Surgery Global Open Pub Date : 2024-10-28 eCollection Date: 2024-10-01 DOI:10.1097/GOX.0000000000006232
Kittituch Banjongleelahong, Tara Vongviriyangoon, Parkpoom Piyaman, Nutthawut Akaranuchat
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引用次数: 0

Abstract

Background: The medial sural artery perforator (MSAP) flap is thin, pliable, and versatile. This study aims to understand the anatomical basis of the MSAP flap and the subcutaneous course of the perforator for safe flap thinning.

Methods: A total of 24 MSAP flaps were dissected under red silicone dye injection guidance. Full-thickness horizontal slides of flaps were performed, and the perforator courses were identified in the subcutaneous plane. Slides were placed on a millimeter board, and the perforator patterns were photographed and observed with loupes.

Results: A total of 68 perforator courses were identified: type 1: 30.9%, type 2: 57.3%, and type 3: 11.8%. They traveled 1-25 mm to the subdermal plexus, with percentile 2.5 at 1 mm, percentile 90 at 18.2 mm, percentile 95 at 21.65 mm, and percentile 100 at 25 mm. The mean flap thickness was 7.75 ± 1.7 mm, with an average of 5.7 ± 1.3 perforators per flap. Perforators clustered between 2 and 18.4 cm from the popliteal crease and 0-8 cm from the posterior midline of the leg. The dominant perforators accounted for 45.2% (62 of 137), averaging 2.58 per flap. The medial sural artery branching pattern types were type 1: 37.5%, type 2: 50%, and type 3: 12.5%. The average pedicle length was 16.2 ± 1.3 cm, and the mean external diameter of the medial sural artery was 1.98 ± 0.13 mm.

Conclusions: MSAPs branch within a maximal radius of 2.5 cm after emerging from the deep fascia. To maintain vascularity, the safe suprafascial dissection should be 2.5 cm apart from the point of emerging.

内侧硬膜动脉穿孔器瓣的变薄:内侧硬膜动脉穿孔器分支的解剖学检查。
背景:内侧硬膜外动脉穿孔器(MSAP)皮瓣薄而柔韧,用途广泛。本研究旨在了解 MSAP 皮瓣的解剖学基础以及穿孔器的皮下走向,以便安全地将皮瓣变薄:方法:在红色硅酮染料注射引导下,共解剖了 24 个 MSAP 皮瓣。对皮瓣进行全厚水平切片,并在皮下平面确定穿孔器走向。将切片放在毫米板上,用放大镜拍摄并观察穿孔器形态:结果:共发现 68 条穿孔线:1 型占 30.9%,2 型占 57.3%,3 型占 11.8%。这些穿孔器穿行到皮下神经丛1-25毫米处,1毫米处的穿孔器百分位数为2.5,18.2毫米处的穿孔器百分位数为90,21.65毫米处的穿孔器百分位数为95,25毫米处的穿孔器百分位数为100。皮瓣平均厚度为 7.75 ± 1.7 毫米,每个皮瓣平均有 5.7 ± 1.3 个穿孔。穿孔器集中在距腘窝皱襞 2 到 18.4 厘米之间,距腿部后中线 0 到 8 厘米之间。主要穿孔器占 45.2%(137 个中的 62 个),平均每个皮瓣 2.58 个。内侧硬膜外动脉分支模式类型为 1 型:37.5%,2 型:50%,3 型:12.5%。瓣蒂平均长度为 16.2 ± 1.3 厘米,内侧硬膜外动脉的平均外径为 1.98 ± 0.13 毫米:结论:MSAPs从深筋膜出现后的最大分支半径为2.5厘米。结论:MSAPs 从深筋膜出现后的最大分支半径为 2.5 厘米,为保持血管的完整性,安全的筋膜上剥离应与出现点相距 2.5 厘米。
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来源期刊
CiteScore
2.20
自引率
13.30%
发文量
1584
审稿时长
10 weeks
期刊介绍: Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.
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