Perforator arteries of the medial upper arm: anatomical basis of a new flap donor site

Abstract

The development of perforator flaps' concept based on knowledge on vascular anatomy of the skin represents a major improvement in reconstructive surgery. Succeeding description about vascular territories and anatomical basics of the main donor sites, the study of hidden donor sites, such as medial upper arm, constitutes a new step and an additional refinement. 20 upper limbs of 10 fresh adult cadavers were studied with colored latex injections. The origin and distribution of the perforator arteries of the superior ulnar collateral artery and the brachial artery were investigated. We have noted constant perforator arteries and described the limits of vascular territories of the medial upper arm.

Vascular territories of the medial upper arm—an anatomic study of the vascular basis for individualized flap design

“…After the injections, the individual perforator arteries were located where they pierced the deep fascia. These points were projected on the skin and pricked with the aid of a straight needle and then registered in a specific coordinate system as described by Perignon et al []. Of this, the y ‐axis linked the medial epicondyle with the highest point of the axilla, exactly between the anterior and posterior axillary line and the x ‐axis was perpendicular to the y ‐axis.…”

“…Despite the efforts to evaluate the perforator arteries of the MAF (Chen, Xu, Tang, et al, 2009; Hwang, Lee, Jung, & Chung, ; Perignon, Havet, & Sinna, ), there were no studies regarding the correlation of perforator arteries with cutaneous vascular perfusion zones. Hence, the aim of this anatomical study was to reassess the vascular basis of the MAF by linking injection studies with consecutive perforator mapping, to determine the location and size of skin flaps supplied by different arteries and to provide guidance for individual flap design.…”

A Superior Ulnar Collateral Artery Perforator Flap for a Large Defect on the Posterior Upper Arm

“…1 Succeeding description about vascular territories and anatomical basics of the main donor sites, the study of hidden donor sites, such as medial upper arm, constitute a new step and an additional refinement. 2 The proximal ulnar artery has several branches, including perforators that are directly derived from the ulnar artery and anterior/posterior recurrent arteries. There are only a few reports of flaps that use the anterior or posterior recurrent arteries.…”

Medial elbow reconstruction with perforator based medial arm propeller flap

“…An anatomic study determined that there are two areas, 7.5 and 8.2 cm, proximal to the medial epicondyle in the medial arm. These areas always contain at least one perforator [23].…”

“…Medial arm skin flap is a great alternative for reconstruction of medial elbow soft-tissue defects. The vascular pedicle of the medial arm flap is supplied by the perforator arteries of the superior ulnar collateral artery and the brachial artery [7,8] (Figure1).…”