[Anatomical basis of the flap based on the perforator of the deep palmar arch].

Abstract

Objective: To investigate the morphological characters of the dorsal perforators originated from the deep palmar arch,so as to provide anatomic basis for V-Y advanced perforator flap.

Methods: The following contents were investigated in 30 aduh hand specimens perfused with red latex under surgical magnifier:① The origin, courses, branches and distribution of the dorsal perforators originated from the deep palmar arch. ②The characters of anastomosis among the dorsal perforators, the dorsal carpal and metacarpal arteries. Mimic operation was performed on another fresh specimens perfused with red latex.

Results: There were three perforators originated from the deep palmar arch, which passed through the 2nd-4th dorsal interossei and then divided into an ascending branch and a descending branch at the dorsum of hand. Then the ascending branch anastomosed with the dorsal carpal artery, and the descending branch stretched to the 2nd-4th dorsal metacarpal arteries. The originating outer diameters of the 1st-3rd perforators were (1.1 ±0.2) mm,(0.9 ±0.3) mm and (0.7 ±0.1) mm respectively, and the length of the stems were (1.1 ±0.3) cm,(1.0 ±0.2)cm and (0.9 ±0.1) cm respectively.

Conclusions: The V-Y advanced perforator flap with the dorsal perforator of the deep palmar arch as its vascular pedicle could be used to repair the dorsal carpal or dorsal metacarpal soft tissue defects.