Anteromedial thigh flaps: An anatomical study to localize and classify anteromedial thigh perforators

Abstract

Until now, research on flaps in the anteromedial thigh region has focused on flaps in specific regions. To elucidate the complete pattern of suitable anteromedial thigh perforators, an anatomical study was performed by dissecting nine thighs from different cadavers. The ideal perforator has maximum length and diameter and runs through a septum. According to the data found in our study, these perforators can predominantly be found in the middle third of the anteromedial thigh region. All of the three main thigh vessels supply perforators which can be used for flaps. Pertaining to length and diameter the most suitable perforators originate from the deep femoral artery, which can be found in the proximal and middle third of the anteromedial thigh. Musculocutaneous perforators are found to be longer than septocutaneous perforators. Because of their position, the proximal and distal third perforators should preferentially be used for local pedicled flaps. Defects in the pelvic area and around the knee can be closed with perforator flaps from the proximal and distal anteromedial thigh, respectively. Because of their diameter, length, and number, the middle third perforators should be the first choice for harvesting free flaps. Skin closure is easily achieved in the anteromedial thigh region even when larger flaps are used.

Deep inferior epigastric perforator flap: An anatomical study of the perforators and local vascular differences

“…The relatively recent interest in perforator flaps has once again sparked interest in the vascular anatomy of surgical flaps. 15,16 Until recently, the Hartrampf perfusion zones were standard for selection of the DIEP flap tissue, but more recent studies show that the establishment of zoning is somewhat complex and contradictory. [17][18][19][20][21] We used the gelatin injection technique to define the vascular anatomy of the lower abdominal wall parts.…”

Clinical anatomical study and evaluation of the use of the free anteromedial thigh perforator flaps in reconstructions of the head and neck

“…13,14 There are few reports of the exact vascular anatomy of the AMT perforator flap, and even fewer that provide details of the size and sites of the perforators. The difference between our study and those of other groups are: first, all the patients in our series were live subjects being operated on in a normal setting.…”

“…1). 13 The length of the pedicle and the thickness of the subcutaneous tissue in the donor territory were also recorded.…”

“…1,2,8 However, there are only a few reports on the use of the anteromedial thigh (AMT) perforator flap, [9][10][11] which was first described by Song et al 12 Although some studies on cutaneous vascularity (through dissection of cadavers), and on the clinical applications of the flap, have been published there is a lack of detailed anatomical information about the site, distribution, source vessel, and properties of anteromedial thigh perforators in operative settings. [9][10][11][12][13][14] The aim of this study was to document objectively and comprehensively the topographic characteristics and clinical outcomes of the use of the AMT perforator flap in reconstruction of defects after resection of tumours from the head and neck.…”

The Anteromedial Thigh Free Flap Anatomy

“…[8][9][10][11][26][27][28] These described indications for anteromedial thigh flap use are generally related to chimeric flaps 8,28 or, as an alternative procedure in case of a lack of or intraoperative damage to perforators, during anterolateral thigh flap harvest. 6,29 Following these first descriptions, other studies described the origin of the pedicle of the anteromedial thigh flap, [9][10][11][12][30][31][32][33] and only more recent studies [34][35][36][37] focused on the number, position, caliber, and type of anteromedial thigh perforators.…”