Superficial Circumflex Iliac Artery Perforator Flap: An Anatomical Study of the Correlation of the Superficial and the Deep Branches of the Artery and Evaluation of Perfusion from the Deep Branch to the Sartorius Muscle and the Iliac Bone

Abstract

Background: Harvesting the sartorius muscle and the iliac bone with a superficial circumflex iliac artery (SCIA) perforator flap can be a challenging procedure. The aim of this study was to describe the anatomical topology of the deep branch of the SCIA in fresh cadavers, which has not been reported in detail. Methods: Twenty groin regions from 10 fresh cadavers were dissected. The characteristics and landmarks of the SCIA system, including branches to the sartorius muscle and the iliac bone, were examined. Perfusion of the sartorius muscle and the iliac bone by means of the deep branch of the SCIA was evaluated with indocyanine green angiography and computed tomographic angiography. Results: The superficial and the deep branches were identifiable in all specimens. In 85 percent of the specimens, the bifurcation point could be seen within 2 cm from a fixed site: 6 cm from the pubic tubercle to the anterior superior iliac spine, and 3 cm caudal from that point. The deep branch in each case gave off branches to the sartorius muscle and the iliac bone. The cephalad portion of the sartorius muscle (up to 8 cm from the anterior superior iliac spine) and the superficial portion of the iliac bone (up to 1.5 cm from the iliac crest) were perfused by the deep branch of the SCIA. Conclusions: In all specimens, both the superficial branch and the deep branch of the SCIA were found. The deep branch was found consistently to give off perfusing branches to the sartorius muscle and the iliac bone.

Novel Classification of the Branching Patterns of the Superficial Branch and the Deep Branch of the Superficial Circumflex Iliac Artery and the Superficial Inferior Epigastric Artery on Computed Tomographic Angiography

“…19 20 A chimeric flap can be procured with a skin flap based on the superficial branch and the sartorius muscle or the iliac bone based on the deep branch of the SCIA. 8 21 22…”

“…Besides, the literature shows an overall paucity of information on the anatomy of the SCIA deep branch. 8 9…”

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

“…The anterior thigh area has extensive surgical applications and is used for a variety of pediculated flaps such as the anterolateral thigh flap 1 , the anteromedial thigh flap 2; 3 , the tensor fascia lata flap 4 , the adductor/deep femoral (profunda femoris) artery perforator flap 5 , the vastus lateralis flap 6 or the rectus femoris flap 7 . However, only the thigh area adjacent to the inguinal ligament that is irrigated primarily by the superficial circumflex iliac artery and its perforators (SCIAP) 8 has the advantages of containing a glabrous skin flap that is both thin and flexible [9][10][11][12][13][14] . This flap offers a valuable skin replacement and serves multiple applications, such as maxilla-facial reconstructive surgery 15 , finger and toe reconstruction 16 and perineal reconstruction 17 , leaving only a discreet scar at the donor site.…”

Maximizing the Versatility of Thin Flap from the Groin Area as a Workhorse Flap: The Selective Use of Superficial Circumflex Iliac Artery Perforator (SCIP) Free Flap and Superficial Inferior Epigastric Artery (SIEA) Free Flap with Precise Preoperative Planning

“…3 4 Further anatomic studies clarified the medial and lateral branches of superficial circumflex iliac artery (SCIA), which help to achieve a better outcome, harvest with multiple components, and better vascular supply. 5 6 With regard to the vascular anatomy of the groin area, the superficial inferior epigastric artery (SIEA) could be also the candidate of pedicle vessels. The SIEA flap has been usually used as an autologous breast reconstruction alternative of the deep inferior epigastric artery flap.…”