Posterior intercostal artery perforator flap for posterior trunk reconstruction: Perforator mapping with high-resolution ultrasound and clinical application

Schmidt, Manfred; Möritz, Thomas; Shamiyeh, Andreas; Zaussinger, Maximilian; Jakobus, Julia; Duscher, Dominik; Machens, Hans‐Günther; Huemer, Georg M.

doi:10.1016/j.bjps.2018.12.005

Cited by 6 publications

(7 citation statements)

References 24 publications

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“…The lowest ICAP was cranially located 2‐5 and 7‐11 cm posterior to the ASIS; from that point, ICAPs were cranially identified every 2.5‐3 cm, and they could be included in SCIP flap. The average diameter was reported as 0.7 ± 0.24 mm 10,12 . On the contrary, the mean number of the radial artery perforators was reported as 10 and 8 on the radial and ulnar side, respectively.…”

Section: Discussionmentioning

confidence: 94%

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A case of a superficial circumflex iliac perforator‐intercostal artery perforator (SCIP‐ICAP) compound flap for necrotizing soft tissue infection

Furuse

Kato

Morishita

et al. 2020

Clinical Case Reports

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Section: Discussionmentioning

confidence: 94%

“…The average diameter was reported as 0.7 ± 0.24 mm. 10,12 On the contrary, the mean number of the radial artery perforators was reported as 10 and 8 on the radial and ulnar side, respectively. The average diameters were 1.11 and 0.86 mm on the distal and proximal side, respectively 13 ; these matched the diameter of the ICAPs.…”

Section: Discussionmentioning

confidence: 99%

A case of a superficial circumflex iliac perforator‐intercostal artery perforator (SCIP‐ICAP) compound flap for necrotizing soft tissue infection

Furuse

Kato

Morishita

et al. 2020

Clinical Case Reports

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“…Schmidt et al [ 15 ] used high-resolution ultrasonography to study PICAPs. They found that the mean diameter was 0.7 ± 0.24 mm with a mean length of 0.8 ± 0.8 cm.…”

Section: Discussionmentioning

confidence: 99%

Posterior intercostal flap: an anatomical study and best flap design

Elzawawy

Kelada

2022

World J Surg Onc

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Background Posterior intercostal arteries perforators (PICAPs) and lateral intercostal arteries perforators (LICAPs) are great vascular pedicles. Between the 4th and 11th spaces, they arise from the thoracic aorta. These are large perforators that can be the basis of many flaps. Yet, these perforators are underrated as they are poorly studied and scarcely utilized in plastic reconstructions. Methods Twenty (ten males and ten females) adult cadaveric dissections were done on both sides to study the types, locations, and sizes of posterior intercostal perforators to help design flaps based on them in the best possible way. Perforators were assigned into one of 3 topographical zones of the back (medial, intermediate, and lateral). Results The skin of the back was divided into 3 vertical zones: medial, intermediate, and lateral. Posterior intercostal arteries perforators (PICAPs) were found in the medial and intermediate zones. Medial zone PICAPs were large and appeared at the medial border of erector spinae (Es). Intermediate zone PICAPs appeared at the lateral border of Es and passed through latissimus dorsi (Ld) before reaching the skin. Lateral zone perforators were branches of lateral intercostal arteries and were divided into 2 types: (1) posterior branches of lateral intercostal perforators: simply named posterior lateral perforators (PLs); they were small and present in most of the spaces, and (2) anterior branches of lateral intercostal perforators (LICAPs): they were large, dominant pedicles and were found mainly in the 4th to the 7th spaces. Conclusion PICAPs and LICAPs are constant and of enormous size and run for a great distance in the skin. They can be utilized as any type of flap.

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“…Despite the previously mentioned 2 kinds of perforator flaps, the most commonly used perforator flap in the trapezius region is based on the dorsal intercostal artery. [27][28][29][30][31][32] The upper 8 dorsal intercostal arteries give branches penetrating through the trapezius to the overlying skin and anastomose with the superficial cervical and dorsal scapular arteries. 1,5,7,27 The major cutaneous perforators can be branches from 1 or more posterior intercostal arteries.…”

Section: Discussionmentioning

confidence: 99%

“…The dorsal intercostal artery perforators are located up to 5 cm from the midline. 27,29 The possibility of confusion exists between them and those from the superficial cervical and dorsal scapular arteries. Distinguishing between them requires retrograde dissection or elevation of the trapezius.…”

Section: Discussionmentioning

confidence: 99%

Trapezius Perforator Flaps Based on Superficial Cervical Artery and Dorsal Scapular Artery

Wang

Li²,

et al. 2022

Ann Plast Surg

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Background: The flaps in the trapezius region are routinely elevated as musculocutaneous flaps. The anatomy of trapezius perforators and their clinical application are unclear. Methods: The number and distribution of superficial cervical artery perforators (SCAPs) and dorsal scapular artery perforators (DSAPs) were studied on 8 cadavers. The clinical usage of SCAP and DSAP flaps was investigated through a systematic literature review. Results: A total of 27 SCAPs and 28 DSAPs were found in the 16 hemibacks. The mean calibers of SCAP and DSAP were 0.9 ± 0.2 and 0.8 ± 0.2 mm, respectively. The vascular length to the takeoff of the source artery was 7.3 ± 2.0 cm (range, 4.7-9.7 cm) for SCAPs and was 8.1 ± 2.8 cm (range, 3.2-13.6 cm) for DSAPs. Contour and density heat maps showed that the SCAPs were clustered within approximately 3 to 5 cm above the horizontal line through the medial point of the scapular spine (x-axis) and 5 to 8 cm from the midline (y-axis, P = 0.001) and clustered DSAPs located in approximately 4 to 9 cm below the x-axis and 4 to 10 cm from the y-axis ( P = 0.002). Four SCAP and 19 DSAP flaps were found in literature. The mean sizes of SCAP flaps and DSAP flaps were 18.5 Â 7.8 and 16.5 Â 8.7 cm, respectively. Conclusions: Both SCAP and DSAP flaps can be elevated with a relatively long pedicle. The anatomical knowledge of the location of major clusters of perforators contributes to the application of these flaps.

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Posterior intercostal artery perforator flap for posterior trunk reconstruction: Perforator mapping with high-resolution ultrasound and clinical application

Cited by 6 publications

References 24 publications

A case of a superficial circumflex iliac perforator‐intercostal artery perforator (SCIP‐ICAP) compound flap for necrotizing soft tissue infection

A case of a superficial circumflex iliac perforator‐intercostal artery perforator (SCIP‐ICAP) compound flap for necrotizing soft tissue infection

Posterior intercostal flap: an anatomical study and best flap design

Trapezius Perforator Flaps Based on Superficial Cervical Artery and Dorsal Scapular Artery

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