The vascular exploration of the proximal femoral artery perforator region, an ideal donor site to choose cutaneous flaps of thin, supple, and glabrous skin: A cadaveric study

Grabs, Detlev; Faghahati, S.; Lampron, Audrey; Sobczak, Stéphane; Maranzano, Josefina; Nayouf, Anna

doi:10.1016/j.bjps.2020.12.082

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…Grabs et al 18 carried out a cadaveric dissection of the perforators of the SFA. They found 30 superior, 35 inferolateral, and 27 inferomedial arterial pedicles.…”

Section: Discussionmentioning

confidence: 99%

Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap

et al. 2022

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Background: Specific perforator-based flaps are a new era in plastic reconstruction. They have replaced many of the traditional paradigms in plastic surgery. The anteromedial thigh flap is a versatile flap that can be used as a primary choice for many reconstructive purposes or as a secondary choice for the anterolateral thigh flap. Mapping the vascular territory of anteromedial thigh is essential for the proper design of the flap. Aim of the Work: The aim of this work was to study the cutaneous perforators of the anteromedial thigh and explain their significance in flap design. Material and Methods: The material of this study included 30 fresh cadaveric lower limbs. The external iliac artery was injected with colored latex. Superficial and deep dissections were undertaken under a magnifying lens to locate the perforators and identify their type. The length and diameter of the perforators were measured. Results: Anteromedial thigh skin was divided into 6 squares. Squares 1 and 4 are the upper squares and comprise the skin over the upper medial thigh. It is primarily based on the superficial external pudendal artery, deep external pudendal artery, and superficial circumflex femoral artery. Squares 2 and 5 are the middle squares and were mainly supplied by perforators of the superficial femoral artery. Squares 3 and 6 are the lower squares and were mainly supplied by the saphenous artery and superficial femoral artery. The possible flap designs are then discussed. Conclusion:The anteromedial thigh skin is richly supplied by a mixture of perforators from multiple sources. The segmental nature of the perforators arising from the superficial external pudendal artery, deep external pudendal artery, superficial femoral artery, and saphenous artery together with the long course and large diameter of perforators grant the anteromedial thigh flap its versatility.

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“…Grabs et al 18 carried out a cadaveric dissection of the perforators of the SFA. They found 30 superior, 35 inferolateral, and 27 inferomedial arterial pedicles.…”

Section: Discussionmentioning

confidence: 99%

Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap

et al. 2022

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“…Although underused in head and neck reconstruction, the profunda femoris artery perforator flap (PAPF) has been gaining popularity in breast reconstruction, second only to the deep inferior epigastric perforator flap 7–9 . Contrary to ALTPF's unpredictable vasculature, the PAPF is an alternative with stable existence of sizable perforators from the profunda femoral artery 9–12 . Additionally, PAPF harvesting leaves a less visible scar in the posterior gluteal crease, thus optimizing donor site cosmesis 13 .…”

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confidence: 99%

“…15 Despite these advantages, there is a paucity of literature describing PAPF utilization in head and neck reconstructions. [7][8][9][10] Here we describe our experience, including pearls and pitfalls associated with the harvest, the chimeric/composite patterns, and the functional outcomes.…”

mentioning

confidence: 99%

“…[7][8][9] Contrary to ALTPF's unpredictable vasculature, the PAPF is an alternative with stable existence of sizable perforators from the profunda femoral artery. [9][10][11][12] Additionally, PAPF harvesting leaves a less visible scar in the posterior gluteal crease, thus optimizing donor site cosmesis. 13 In slim patients, PAPFs provide larger volumes for defect coverage than either deep inferior epigastric perforator flaps or ALTPFs, 14 while in obese ones, PAPFs can be thinned.…”

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confidence: 99%

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Profunda Artery Perforator Flaps From the Posteromedial Region of the Thigh for Head and Neck Reconstruction

Gao

Zhu

et al. 2022

Otolaryngol.--head neck surg.

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Objective Profunda femoris artery perforator flaps (PAPFs) have not been widely used in head and neck reconstructions. The feasibility and outcomes of PAPFs for various head and neck reconstructions need to be investigated. Study Design Retrospective analysis. Setting A single-institution review. Methods PAPFs were utilized in head and neck reconstructions from 2019 to 2021. Local anatomy, surgical technique, and complications were discussed. Chimeric PAPF applications with muscle components were described for coverage of extensive multiunit defects. Additionally, aesthetic and functional outcomes were compared with anterolateral thigh perforator flaps. Results A total of 33 cases were included. The average age was 54.2 years (range, 30-74). The most common underlying pathology was oral squamous cell carcinoma (n = 26, 78.8%), while the mean ± SD body mass index was 25.4 ± 2.8 kg/m2. Middle perforators (n = 14, 42.4%) were the most commonly utilized ones. The perforator-based chimeric/composite applications were used in 9 (27.3%), with the muscular components consisting of gracilis (n = 3, 9.1%), adductor magnus (n = 5, 15.2%), or semimembranosus muscles (n = 1, 3.0%). Venous thromboses of the PAPFs were found in 2 (6.1%), though salvaged. The occurrence of postoperative 90-day morbidity (complication) was related to mandibulectomy/maxillectomy ( P = .020). Postoperative validated questionnaires showed a trend of intermediate to high scores, indicating noninferior outcomes in several categories, when compared with the anterolateral thigh perforator flap counterparts. Conclusion PAPFs are a good reconstructive alternative for intermediate to large head and neck reconstructions. Besides, PAPFs can provide sufficient tissue volume and versatility of potentially incorporating adjacent muscle components.

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Application of a pre-expanded cross-legged tubed flap to reconstruct extensive GCMN of distal lower limb in children

Yang,

Han,

Fan

et al. 2023

Eur J Plast Surg

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The vascular exploration of the proximal femoral artery perforator region, an ideal donor site to choose cutaneous flaps of thin, supple, and glabrous skin: A cadaveric study

Cited by 3 publications

References 31 publications

Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap

Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap

Profunda Artery Perforator Flaps From the Posteromedial Region of the Thigh for Head and Neck Reconstruction

Application of a pre-expanded cross-legged tubed flap to reconstruct extensive GCMN of distal lower limb in children

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