Motifs de l'angiosome de l'artère faciale

Du territoire cutané des perforantes de l artère faciale, l étude que nous avons réalisée au laboratoire d anatomie de la faculté d Amiens apporte la première description faite à ce jour. Vingt artères faciales ont été disséquées, les perforantes cutanées individualisées puis injectées par une solution colorée. Les caractéristiques des perforantes et leurs sites d émergence sont détaillés. Leurs projections cutanées ont été reportées sur un système cartésien, recréant ainsi une cartographie détaillée. L analyse des surfaces obtenues après 101 injections sélectives de perforantes permet de conclure à l existence de 7 territoires principaux. L angiosome de l artère faciale apparait comme une mosaïque de territoires qui se révèlent être constants. L étude radiologique chez des sujets volontaires a conforté nos résultats et l échographie haute fréquence couplée au Doppler semble être un instrument de choix pour le repérage préopératoire. La connaissance de la vascularisation cutanée faciale est affinée et offre de nouvelles possibilités de lambeaux locaux en îlot vrai pour des reconstructions sur mesure en un temps.The study we conducted, in the laboratory of anatomy of the Faculty of Amiens, provides the first description of the vascular territories of the facial artery perforators.Twenty facial arteries were dissected, perforators were individualized and injected with a color dye solution. The characteristics of each perforator and their location were detailed. Their cutaneous projections were described using a system of reference and used to recreate a graph of perforator density per cm2. The analysis of the 101 selective injections of perforators allowed us to conclude to the existence of 7 main types of perforator territory. The angiosome of the facial artery appears as a patchwork of territories that seems to be constant. The radiological study in volunteers has confirmed our results and the High frequency Color flow duplex ultrasonography appears to be an instrument of choice before surgery. This study improves our understanding of the facial vascularisation and allows more accurate and one stage reconstructions.AMIENS-BU Santé (800212102) / SudocSudocFranceF

Is the Mastectomy Flap Thickness a Good Predictor of Nipple Areolar Complex Suffering? A Radiological Study of 73 Breasts before Nipple Sparing Mastectomy.

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Pre-expanded thin DIEP free flap in pediatric upper extremity reconstruction for burn sequelae: A case report

International audienceDeep burns sequelae involving the upper limb are challenging even for experienced surgeons, mainly because local reconstructive options and donor sites are often compromised. The use of free flaps for this type of reconstruction remains difficult due to the small recipient vessel diameter and tendency to vasospasm. Moreover, pediatric cases bring the challenge to another level. We present the case of a 13-year-old girl presenting major retractile sequelae of the upper left limb, including complete wrist immobilization combining wrist hyper-extension, ulnar deviation deformity, and a ulno-carpal dislocation. She was referred to our department where a two-stage reconstruction was performed using a pre-expanded free deep inferior epigastric artery perforator (DIEP) flap. The first surgery consisted of placing two kidney-shaped expanders in a subfascial plane in the hypogastric region. Four months later, after a bi-weekly expansion, an excision of the scar tissue, and the DIEP flap transfer were completed. At the 12-month follow-up evaluation, both aesthetic and functional results were satisfactory, with a good contour and regained mobility of the wrist