The inferiorly based gastrocnemius muscle flap: Anatomic aspects

The arterial communication between the gastrocnemius muscle heads through their lowest anastomotic arteriole bundle alone was examined in specimens from 14 fresh cadavers. In 3 specimens, the larger vessels in close vicinity to the lowest vessels were preserved as well. Distinct communication between the arterial networks of the heads was demonstrated in all cases after injecting dyes through both sural arteries or into die lateral sural artery and the lowest anastomotic arteriole in 11 and 3 specimens, respectively. Therefore, it seems that one head can be adequately supplied from the contralateral one through their lowest anastomotic arteriole(s); nevertheless, the location of this vessel varies significantly and cannot be detected preoperatively. Measurements demonstrated that although this vessel is not found at a constant level, it is invariably detected in the lower third of the medial gastrocnemius head’s length and, in 93 percent of cases, in the lower fourth. Thus, rough preoperative planning becomes feasible. Given that the venous communication between the heads has been documented as well, the authors think that an inferiorly based flap of the medial gastrocnemius head for defects of the middle third of the tibia might be both reliable and applicable; however, for reasons of safety, the muscle heads should remain attached along their lower third

The arterial communication between the gastrocnemius muscle heads: A fresh cadaveric study and clinical implications

The purpose of this investigation was to describe the anatomy of the communicating (anastomotic) vessels between the gastrocnemius muscle heads and to record the extent of their supply potential. Ensuing clinical implications are discussed. Fourteen fresh cadaveric gastrocnemius muscles were examined. Detailed dissections of the communicating vessels were facilitated after injections of methylene blue or cadaveric blood solutions through the medial, lateral, or both sural arteries. The extent of the arterial cross-supply between the muscles’ heads through these vessels was determined in eight specimens after methylene blue perfusions through the lateral sural arteries, while one specimen was examined after injection of methylene blue and yellow ink through the lateral and medial sural arteries, respectively. Communicating vessels were detected in all 14 specimens. A mean number of 5.8 vascular bundles and single vessels was found. The bundles consisted of arterioles and, as all indications suggested, of concomitant venules as well. Regarding arterial cross-supply, it was clearly evident that each head could be vascularized solely from the contralateral one, mostly through these bundles. However, even if only a part of the bundles was preserved intact, vasculature was not affected

The biceps femoris short head muscle flap: An experimental anatomical study

The vascular communication between the heads of the biceps femoris muscle has been established after 25 cadaveric dissections. Perfusions of dye through the long or the short head consistently showed 1-2 anastomotic bundles. Outflow of dye opposite to the site of the perfused head was remarkable in most cases. Intramuscular dissections disclosed broad and well structured vascular networks in all short heads, but this was not true for all long heads. Our observations suggest that the anastomotic vessels alone might support the short head which, when released from its profunda femoris vessels, is adequate to cover lateral knee defects. Depending on the level of the anastomotic vessels, the proximal or the distal part of the short head should be used. A pedicled flap may be used as well, whereas transsection of the biceps tendon offers additional mobility

Molecular aspects of the H2 activation on MoS2 based catalysts - the role of dynamic surface arrangements

10.1097/01.PRS.0000141485.83476.89Plastic and Reconstructive Surgery11461665-1666PRSU