Document Detail

First cutaneous branch of the internal pudendal artery: an anatomical basis for the so-called gluteal fold flap.
MedLine Citation:
PMID:  11552287     Owner:  NLM     Status:  MEDLINE    
We investigated the cutaneous blood supply in the gluteal and perineal regions of 35 donated cadavers to provide an anatomical basis for reliable vulvo-vaginal reconstruction using a skin flap such as the so-called gluteal fold flap. The cutaneous areas along the gluteal cleft and sulcus were likely to be supplied by 3 routes: 1) the internal pudendal artery (IPA), especially its first cutaneous branch; 2) perforators running through the gluteus maximus muscle and arising from the inferior gluteal artery (IGA); and 3) a non-perforator running around and inferior to the ischial tuberosity and originating from the IGA. Route 1 supplied the skin along the gluteal cleft, route 2 the gluteal fold (i.e., a bulky skin fold along the upper edge of the gluteal sulcus), and route 3, just along the gluteal sulcus. In those 3 routes, we noted the consistent morphology of the thick and long, first cutaneous branch of the IPA. The first arterial branch, 1.5 mm in diameter at its origin on average (ranging from 0.7-2.6 mm), usually originated from the IPA under the cover of or at the inferomedial or distal side of the sacrotuberous ligament (almost always less than 20 mm from the inferomedial margin of the ligament). The branch ran superomedially toward the coccyx or ran medially in the ischiorectal fat. It accompanied the vein and nerve at its distal (peripheral) course although the nerve often ran independently at its proxomal course near the ligament. Therefore, the first branch of the IPA seems to provide a reliable pedicle using the skin along the gluteal cleft whether the incision for approach is conducted along the gluteal sulcus or not. However, if the gluteus maximus muscle extended much inferomedially, the pedicle would be very short. In this case, preparation of the pedicle seems to be necessary along the arterial course under the cover of the muscle.
I Hashimoto; G Murakami; H Nakanishi; H Sakata-Haga; T Seike; T J Sato; Y Fukui
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Okajimas folia anatomica Japonica     Volume:  78     ISSN:  0030-154X     ISO Abbreviation:  Okajimas Folia Anat Jpn     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-09-12     Completed Date:  2001-10-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401014     Medline TA:  Okajimas Folia Anat Jpn     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  23-30     Citation Subset:  IM    
Department of Plastic and Reconstructive Surgery, Tokushima University School of Medicine, Tokushima, Japan.
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MeSH Terms
Aged, 80 and over
Buttocks / blood supply*,  surgery
Iliac Artery / anatomy & histology*
Middle Aged
Surgical Flaps / blood supply*
Vulva / blood supply*,  surgery

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