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

Abstract

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.

The Posteromedial Thigh Flap for Head and Neck Reconstruction

“…20 The dominant blood supply of this anatomical area originates from the profunda femoris artery. 21 It runs distally and provides at least two perforators (85 percent of cases: three or more perforators) that are distributed evenly between the medial and lateral halves of the thigh.…”

Breast Reconstruction Using the Geometrically Modified Profunda Artery Perforator Flap From the Posteromedial Thigh Region

“…Our earlier anatomical studies revealed longer and larger perforators in the posterior thigh region when compared with those in the anteromedial thigh region. 21,22 Previously reported average pedicle length of the PAP flap was 10.6 cm in a cadaveric study versus 9.9 cm in a clinical study ( Table 2). 19,20 In the current study, the average pedicle length was 11.0 cm.…”

“…In our initial experience, this original technique occasionally resulted in limited flap volume and caudal scar migration. Advancing on Allen's aforementioned work and our perforator studies of the leg, [21][22][23][24] we modified the PAP flap geometrically and applied it in a series of breast reconstruction cases.…”

A comparative study of vascular injection fluids in fresh‐frozen and embalmed human cadaver forearms

“…In addition, Hupkens et al. (, ) described a way to harden acrylic paint by leaving the limb in dry air for 1 day, followed by freezing for the next 2 days and thawing it for 1 or 2 days.…”