Perforator mapping in the trunk: a guide for freestyle flap surgery and an introduction to the sustainable anatomical study

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Introduction: Freestyle Perforator flaps minimize flap harvestmorbidity and can be harvested anywhere in the body ifperforators anatomy is well known. A study of trunk perforatorvessels has been performed on recycled CT scans avoiding cadaverinvestigations or unnecessary radiation exposure.Materials and Methods: 200 CT scans, performed for thestudy of liver or pancreatic disease, were examined. No unnecessaryradiation was administered. Previous abdominal surgery wasreason of exclusion. The trunk between the xyphoid process andDownloaded by:Biomedische Bibliotheek193.191.170.2 - 10/8/2014 8:35:28 AMAbstracts Eur Surg Res 2012;49:130–216 215the umbilicus was studied. On axial scans, the trunk was dividedin 4 quadrants: Q1 anterior right, Q2 anterior left, Q3 posteriorleft, Q4 posterior right,. Scans were examined and the position ofany perforator >1mm in caliber was measured. The values weretransferred on a MS excel® data sheet and analyzed.Results: The average number of perforators per patient was25,63 (6,09 Q1, 7,21 Q2, 6,20 Q3, 6,14 Q4). Anteriorly, the majorityof perforators were between 0 and 5cm from the midline, whileposteriorly between 5 and 10 cm. The perforators are more numerousand symmetric anteriorly (Q1 and Q2). Perforators coursewithin the subcutaneous tissue was vertical or oblique for perforatorsof the Superior Epigastric Artery, horizontal or oblique forperforators of the lateral intercostal arteries, vertical or oblique forperforators of the posterior intercostal arteries.Conclusions: The region of the trunk between the xyphoidprocess and the umbilicus has several perforators of more than1mm in caliber that might potentially be used as pedicle of freestyleflaps. This study provides a map of the location of perforatorin the middle trunk to serve as a guide for the surgeon to harvestfree style flaps in this area. This study also introduces the conceptof recycling existing CT scans for the purposes of anatomicalinvestigation and might encourage others to exploit
Lingua originaleEnglish
Numero di pagine2
Stato di pubblicazionePublished - 2012


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