Biceps Femoris Perforator Free Flap for Upper Extremity Reconstruction: Anatomical Study and Clinical Series

Cavadas, Pedro C.; Sanz-Jiménez-Rico, Juan Ramón; Landín, Luis; Correa, Jesus A.

doi:10.1097/01.prs.0000169720.89323.47

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…The majority of musculocutaneous perforators was found to pierce the adductor magnus muscles followed, in decreasing numbers, by the gracilis muscle and the biceps femoris muscle. These findings are in accordance with preliminary studies which were focused on subunits of the PTR …”

Section: Discussionsupporting

confidence: 93%

“…These findings are in accordance with preliminary studies which were focused on subunits of the PTR. [8][9][10][11][12][13][23][24][25][26] Recently the PTR has become a donor site for autologous breast reconstructions. Allen et al, 27 described successful breast reconstructions using profunda artery perforator flaps in patients in whom an abdominal flap was not possible because of earlier abdominal surgery and/or inadequate abdominal tissue.…”

Section: Discussionmentioning

confidence: 99%

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Posterior thigh perforator flaps: An anatomical study to localize and classify posterior thigh perforators

et al. 2013

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In the last decade perforator flaps have been used increasingly for different indications. Many regions may serve as donor site. In this respect the posterior thigh region (PTR) has been neglected as a potential donor site for many years. The purpose of this study was to provide complete mapping of perforators supplying the posterior thigh region. Twelve fresh cadaver thighs were prepared injecting diluted acrylic paint into the iliac artery. Thereafter the posterior thighs were dissected from medial to lateral, distinguishing the perforators at the level of the superficial fascia. The perforators were localized and origin, source, length and diameter of the perforators were documented. Analysis occurred using ANOVA and the two proportion Z test. The distribution of musculocutaneous and septocutaneous perforators was respectively 69.1% and 30.9% (P = 0.002). The PTR was divided in thirds. Most perforators (53.2%) were found in de middle third of the PTR. The deep femoral artery (DFA) was the main origin of perforators (61.7%), followed by the superficial femoral artery (SFA) (27.7%) and the popliteal artery (PA) (10.6%). The DFA perforators were the longest with a mean length of 13.7 ± 4,69 cm, the SFA perforators were 9.79 ± 3.76 cm and the PA perforators were 8.6 ± 3.37 cm. The PTR offers a sufficient number of suitable perforators to serve as an adequate donorsite for pedicled and free flaps.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Posterior thigh perforator flaps: An anatomical study to localize and classify posterior thigh perforators

et al. 2013

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“…In reconstructive surgery the number of well established fasciocutaneous perforator flaps is slowly increasing. 1,2 Fasciocutaneous free flaps are frequently used in head and neck reconstructions (anterolateral thigh flap (ALT) 3 ) and breast reconstructions (deep inferior epigastric perforator flap (DIEP) 4 ) The ALT flap has become the first choice for reconstruction of defects where fasciocutanous flaps are needed. 5 The vascular supply of the ALT flap has been extensively described.…”

mentioning

confidence: 99%

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

et al. 2009

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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.

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Predicting perforator location on preoperative imaging for the profunda artery perforator flap

et al. 2012

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Introduction: The profunda artery perforator (PAP) flap is a new addition to our reconstructive armamentarium. In effort to better understand patient candidacy for the PAP flap we characterized the profunda artery perforators on preoperative imaging. Methods: A retrospective review was completed of 40 preoperative posterior thigh computed tomography angiographies and magnetic resonance angiographies by four plastic surgeons. The positioning of the patient, type of study, number of perforators, and size of perforators were documented. The location was documented on an x–y‐axis. Perforator course and surrounding musculature was documented. Results: In 98.8% of posterior thighs suitable profunda artery perforators were identified. The average number and size of perforators was 3.3 and 1.9 mm. The most common perforator was medial (present in 85.6% of thighs); found near the adductor magnus at 3.8 cm from midline and 5.0 cm below the gluteal fold. The second most common perforator was lateral (present in 65.4% of thighs); found near the biceps femoris and vastus lateralis at 12.0 cm from midline and 5.0 cm below the gluteal fold. Nearly 48.3% were purely septocutaneous. And 51.7% had an intramuscular course (average length 5.7 cm). Preoperative imaging corresponded to suitable perforators at the time of dissection of all PAP flaps. Thirty five PAP flaps (18 patients) were performed with 100% flap survival. Conclusion: Analysis of preoperative posterior thigh imaging confirms our intraoperative findings that a considerable number of suitable posterior thigh profunda perforators are present, emerge from the fascia in a common pattern, and are of sufficient caliber to provide adequate flap perfusion and recipient vessel size match. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.

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Biceps Femoris Perforator Free Flap for Upper Extremity Reconstruction: Anatomical Study and Clinical Series

Cited by 4 publications

References 22 publications

Posterior thigh perforator flaps: An anatomical study to localize and classify posterior thigh perforators

Posterior thigh perforator flaps: An anatomical study to localize and classify posterior thigh perforators

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

Predicting perforator location on preoperative imaging for the profunda artery perforator flap

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