Anomalous blood supply to the serratus anterior muscle flap

Fontaine, Serge de; Decker, G; Goldschmidt, Denis

doi:10.1016/0007-1226(94)90035-3

Cited by 13 publications

(12 citation statements)

References 7 publications

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“…The artery was found to traverse through the upper digitations of the muscle, making dissection tedious, but it did not affect the use of the flap. The serratus branch has also been reported to arise from the first intercostal artery, 79 directly from the subscapular artery 80 and the lateral thoracic artery. [81][82][83] It is worth noting that, during dissection of the flap with the underlying rib, pleura can be breached accidentally, and particular care should be taken to avoid this.…”

Section: Discussionmentioning

confidence: 98%

The Free Serratus Anterior Flap and Its Cutaneous Component for Reconstruction of the Face: A Series of 27 Cases

Pittet

Mahajan

Alizadeh

et al. 2006

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 98%

The Free Serratus Anterior Flap and Its Cutaneous Component for Reconstruction of the Face: A Series of 27 Cases

Pittet

Mahajan

Alizadeh

et al. 2006

Plastic and Reconstructive Surgery

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“…8 Our research showed collateral branches to the following muscles: serratus anterior (54% in males, 30 % in females), teres major (26% in males, 40% in females) and sub scapularis (20% in males and 30 % in females). Terminal branches to the following muscles: serratus anterior (50% in males, 64 % in females), latissimus dorsi (50% in males and 26% in females).…”

Section: Discussionmentioning

confidence: 99%

“…Van Thienen mentions the angular artery, while Fontaine et al reaffirm the anatomical variations of the arteries mentioned above and add their description of a case of blood supply of the serratus anterior by the first intercostal artery. 8 The current importance of knowledge of blood supply to the muscles of the scapular region and the controversies that persist in the literature were the reasons for our study of the subscapular artery focusing on new objectives which has not yet been dealt with thoroughly in the existing literature. It is our sincere hope that this study proves useful for surgeons specializing in reparative surgery.…”

mentioning

confidence: 99%

Study of Distribution of Subscapular Artery Branches in Males and Females

Kanaka¹,

E²,

P³

et al. 2015

jemds

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INTRODUCTION: the subscapular arterial tree may be used as a source of microvascular grafts to replace damaged or diseased portions of arteries, particularly in the hand and forearm. The use of muscle patches, myocutaneous, osteomuscular and even muscle fascia in reconstructive surgery of the head, neck and limbs is becoming increasingly frequent. The muscles of the scapular and axillary regions, mainly the serratus anterior and the latissimus dorsi, are among those most commonly used in reparative surgery. The current importance of knowledge of blood supply to the muscles of the scapular region and the controversies that persist in the literature were the reasons for our study of the subscapular artery focusing on new objectives which has not yet been dealt with thoroughly in the existing literature. AIMS AND OBJECTIVES: The motive for this research was the use of the muscles of the scapular region in transposition, transplantation and reparative surgery and the need for more detailed knowledge of the blood supply to these muscles. The development of reparative surgery has demanded more detailed anatomical knowledge of the blood supply and innervation of muscles in general and of those with more significant surgical application in particular. Anatomy textbooks do not describe these structures with the necessary depth, either because they were designed at a time when this type of surgery was only in its early stages, or because descriptions of the structures mentioned above were not their main objective. It is our sincere hope that this study proves useful for surgeons specializing in reparative surgery. MATERIALS AND METHODS: We have studied the axillary artery and its branches in 30 cadavers, of both sexes, aged 26 to 70 years, through routine dissection on the axillary regions on both sides. RESULTS: Our research showed collateral branches to the following muscles: serratus anterior (54% in males, 30 % in females), teres major (26% in males, 40% in females) and sub scapularis (20% in males and 30 % in females). Terminal branches to the following muscles: serratus anterior (50% in males, 64 % in females), latissimus dorsi (50% in males and 26% in females). In males serratus anterior muscle receiving two branches at 2 nd (collateral branch) and 5 th (Terminalbranch) inter coastal spaces where as in females serratus anterior muscle receiving two branches (both are terminal) at 5 th inter coastal spaces. CONCLUSIONS: the site of termination into muscular branches to serratus anterior and latissimus dorsi is higher in males when compared to females. No of collateral branches (Three) more in females when compared to males. In this study the serratus anterior receives two branches (one collateral and one terminal) in males whereas females also present two branches but both of them are terminal.

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“…However, numerous anatomical variations are possible that have been already described in literature. Accordingly, vascular supply can directly arise from the AA, the intercostal artery or the lateral thoracic artery …”

Section: Introductionmentioning

confidence: 99%

“…6 However, numerous anatomical variations are possible that have been already described in literature. Accordingly, vascular supply can directly arise from the AA, 8 the intercostal artery 9,10 or the lateral thoracic artery. 2,11 Particularly for reconstruction of the head and neck, the SAFF offers some significant advantages, including a long and reliable vascular pedicle, the thinness and pliability of the flap, ease of harvest and a low donor site morbidity.…”

mentioning

confidence: 99%

Design of skin islands for a myocutaneous serratus anterior free flap—An anatomical study and clinical implication for pharyngeal reconstruction after laryngopharyngectomy

Janik

Paraszti

Hirtler

et al. 2018

Clinical Otolaryngology

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Objectives The main purpose of this study was to evaluate flap size and flap design of skin islands in myocutaneous serratus anterior free flaps (SAFFs) in fresh cadavers and to further investigate whether myocutaneous SAFFs are suitable flaps for pharyngeal reconstruction after laryngopharyngectomy. Methods Dissection and injection of methylene blue were performed in 20 hemithoraces of 13 fresh cadavers to evaluate flap size and location of skin islands. Based on these pre‐clinical data, we performed pharyngeal reconstruction with myocutaneous SAFF in five patients after laryngopharyngectomy. Results Perfused skin paddles were found in all specimens with a mean size of perfused skin islands of 85.6 ± 49.8 cm2. Lengths and widths of skin islands ranged from 10‐21 cm and 6‐20.5 cm respectively. Flap size did not significantly differ between males and females (P = 0.998), left compared to right hemithoraces (P = 0.468) and between paired specimens (P = 0.915). All skin islands were found within the upper 29.3%‐51.7% of hemithorax (calculated from axilla to costal arch), and between latissimus dorsi muscle posteriorly and anterior axillary line anteriorly. Accordingly, myocutaneous SAFFs were used for pharyngeal reconstruction after laryngopharyngectomy in five patients with advanced hypopharyngeal carcinomas. Three patients had uneventful courses, while one patient developed immediate intraoperative flap loss and another patient developed partial necrosis of SAFF on postoperative day 7. Conclusion Skin islands of SAFF have reliable blood supply, which allow harvest of large myocutaneous SAFFs that can be used also for pharyngeal reconstruction after laryngopharyngectomy.

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Anomalous blood supply to the serratus anterior muscle flap

Cited by 13 publications

References 7 publications

The Free Serratus Anterior Flap and Its Cutaneous Component for Reconstruction of the Face: A Series of 27 Cases

The Free Serratus Anterior Flap and Its Cutaneous Component for Reconstruction of the Face: A Series of 27 Cases

Study of Distribution of Subscapular Artery Branches in Males and Females

Design of skin islands for a myocutaneous serratus anterior free flap—An anatomical study and clinical implication for pharyngeal reconstruction after laryngopharyngectomy

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