Document Detail

The anatomic and radiologic basis of the circumflex scapular artery perforator flap.
MedLine Citation:
PMID:  20489408     Owner:  NLM     Status:  MEDLINE    
Microsurgical development has recently focused upon the perforator paradigm and primary thinning. Existing perforator flaps may require intramuscular dissection or lack reliable surface markings, whereas traditional scapular/parascapular flaps have low donor morbidity and reliable anatomy, but can be excessively bulky. Clinical application of a new flap based on a perforator from the circumflex scapular axis (CSA) has recently been published, but the vessel's anatomy has not been adequately characterized. The CSA was dissected in 115 sites in 69 cadavers. The number, external vessel diameter, and site of origin of perforators were measured relative to the CSA bifurcation. Color Doppler ultrasound was used to delineate the CSA and its perforators bilaterally in 40 volunteers. The number, origin relative to CSA bifurcation, diameter, length, and flow velocity of cutaneous perforators were determined. A CSA perforator was always present, running into the subdermal plexus, arising within 2.4 cm of the bifurcation. Cadaver studies: mean perforator diameter, 1.3 mm (SD, 0.66); 13% arose at bifurcation, 36% arose proximal (mean, 1.1 mm; SD, 0.63), and 52% distal to bifurcation (mean, 1.5 mm; SD, 0.88). Ultrasound: mean perforator diameter, 1.18 mm (SD, 0.41); mean flow velocity, 16.3 cm/s (SD, 3.65); perforator arose in 36% proximal, in 40% distal to bifurcation, and in 24% from the bifurcation. We definitively describe the anatomy of the perforator from the circumflex scapular artery upon which a new flap has been based. Its origin and dimensions are anatomically and radiologically reliable. The flap has certain potential benefits over existing perforator flaps.
Jörg Dabernig; Keh O Ong; Robert McGowan; Mikael Wiberg; Anthony P Payne; Andrew M Hart
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  64     ISSN:  1536-3708     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  784-8     Citation Subset:  IM    
Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.
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MeSH Terms
Angiography / methods
Axillary Artery / anatomy & histology
Dissection / methods
Microsurgery / methods
Muscle, Skeletal / anatomy & histology*,  radiography*
Reconstructive Surgical Procedures / methods
Scapula / blood supply
Sensitivity and Specificity
Surgical Flaps / blood supply*

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