Vascular anatomical features of the medial thigh flap in human cadavers of Caucasian origin

Background: Medial fasciocutaneous flaps, which are based on the femoral artery from the thigh region, are used for wide inguinal, scrotal, vaginal, perineal, leg, head and neck defect reconstructions in injured human patients. Within this regard, anatomical knowledge about perforating and cutaneous branches of the femoral artery is important for the surgeons. Materials and methods: In the present study, vascular pedicles of the medial thigh perforator flap based on the femoral artery were investigated according to anatomical and surgical landmarks. Human Caucasian preserved cadavers of 15 adults (13 males, 2 females; age range 55–82 years: 30 sides, bilaterally) that were previously formalin fixed were subjected to our analytical examinations. Micro dissections were performed under 4× loop magnification while representing the perforating branches of the femoral artery after filling by coloured latex injection via the external iliac artery. Results: The size and length parameters of these branches which appeared around the apex of the femoral triangle were evaluated. The mean size of the perforating branch at the point of origin was 0.14 cm and the mean size of the cutaneous branch at the point of origin was 0.09 cm, the mean length of the pedicle was 4.74 cm and the mean length of the cutaneous branch was 3.30 cm, respectively. Location of the perforating and the cutaneous branches were also determined according to the surgical landmarks such as the anterior superior iliac spine, inguinal ligament, pubic tubercle and interepicondylar line. Conclusions: The pedicle of the medial flap should locate up to 25 cm from the anterior superior iliac spine so as to preserve the vascular structures. Exact location of this artery helps the surgeons to perform anastomosis in an easier and safer manner during surgical operations

Arterial anatomy of anconeus muscle flap

Anconeus is a small muscle located in the elbow region. The muscle flap may be used as a pedicled flap for the reconstruction of defects of the same area. There are very few studies conducted on the flap anatomy of this muscle. In this study 15 formalin fixed cadavers were dissected under 4x loupe magnification. The arterial blood supply was found to be posterior recurrent interosseous artery. The mean diameter of the artery was 0.5 mm at the origin. The diameter was found to be too small for using the flap as a free flap. The localization of the pedicle was defined according to easy surgical landmarks. The mean distance of the origin from interepicondylar line and from the proximal tip of the olecranon was 73 mm and 28.9 mm respectively. The average length of the pedicle of the flap was found to be 8.5 mm. The localization of the point where the pedicle entered the muscle was calculated according to the distance from the interepicondylar line. The distance of the muscle entry point of the artery to the interepicondylar line was 65.2 mm (range 8-101 mm). It is concluded that although the pedicle is too small to be used as a free flap its constant anatomy makes the flap an ideal muscle flap for the reconstruction of defects of the elbow region. © 2010 OMU All rights reserved

Anatomic Bases of Superficial Temporal Artery and Temporal Branch of Facial Nerve

The superficial temporal artery (STA)-based flaps have been used for different reconstructive purposes. These operations may cause facial nerve injury. The variations of the STA and its relation to temporal branch of the facial nerve (TBFN) were evaluated in this study. Thirteen cadavers with 26 STA and TBFN have been dissected. The bifurcation of STA was found to be 60% above the superior border of the zygomatic arc and 40% below this level. The mean lengths of frontal and temporal branches (FB and TB) of STA were 11.5 and 11.4 cm, respectively. The mean numbers of perforators of FB and TB to deep plane were 1.30 and 1.34, respectively. The mean diameter of STA at the superior border of zygomatic arc was 2.5 mm. The mean diameters of TB and FB at the level of bifurcation were 1.8 mm and 2.0 mm, respectively. The mean number of TBFN at the level of zygomatic arc was 3.70. The mean distance of the first and last branching of TBFN to tragus was found to be 24 mm. The mean number of TBFN at the level of the middle orbita was found to be 2.7. The mean distance of first and last branches of TBFN to the lateral orbital rim was 12 and 24 mm, respectively. The results found in this study may increase the accuracy of flaps based on STA and decrease the risk of facial nerve paralysis during these operations