Three- and Four-Dimensional Arterial and Venous Perforasomes of the Internal Mammary Artery Perforator Flap

Wong, Corrine; Saint‐Cyr, Michel; Rasko, Yvonne M.; Mojallal, Ali; Bailey, Steven H.; Myers, Simon; Rohrich, Rod J.

doi:10.1097/prs.0b013e3181bf815f

Cited by 59 publications

(26 citation statements)

References 15 publications

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“…A previous study on internal mammary artery perforators showed that the direction of vascular perfusion was perpendicular to the midline (Fig. 6), 24 which supports a transverse orientation of the skin paddle. The donor site was closed primarily.…”

Section: Anterior Trunk (Case 5)mentioning

confidence: 78%

“…Many studies have defined the topography of these perforators and their related flaps. 4 -16 However, the vascular territory of each perforator, the perforasome, is a fairly new concept recently introduced by SaintCyr et al [17][18][19][20][21][22][23][24] Furthermore, the dynamic behavior of the neighboring perforasomes when a perforator flap is harvested is starting to be better understood. Further clinical descriptions and applications will serve to aid in defining the limits of pedicled perforator flaps.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Freestyle Pedicle Perforator Flaps: Clinical Results and Vascular Anatomy

Lecours

Saint‐Cyr

Wong

et al. 2010

Plastic and Reconstructive Surgery

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124

129

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Section: Anterior Trunk (Case 5)mentioning

confidence: 78%

mentioning

confidence: 99%

Freestyle Pedicle Perforator Flaps: Clinical Results and Vascular Anatomy

Lecours

Saint‐Cyr

Wong

et al. 2010

Plastic and Reconstructive Surgery

Self Cite

124

129

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“…Authors agree that second IMA perforator has the widest caliber among all IMA perforators; this supplies the largest area on anterior chest and generally has a transverse course parallel to ribs . Wong et al explained that linking vessels between adjacent IMA perforators allow harvesting large adipocutaneous flaps on single perforator . They indicated that these vessels are located in the subdermal level or along the subcutaneous fat.…”

Section: Discussionmentioning

confidence: 99%

Internal mammary artery perforator propeller flap for contralateral mastectomy defect: A case report

2016

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The internal mammary artery perforator (IMAP) flap can be used as either loco-regional or free flap, and provides thin flexible coverage for defects of the chest wall and cervical regions. In this report, we present a bilateral mastectomy case in which the left mastectomy defect was closed with an IMAP propeller flap harvested from the right breast. Our patient with a history of left breast conservation therapy was diagnosed invasive ductal carcinoma in her left breast 14 years later. On physical examination, the patient's left breast displayed the stigmata of radiotherapy including dark discoloration and firmness to palpation, compared to contralateral pendulous breast. After bilateral mastectomy, an IMAP flap with a size of 26 cm × 11 cm was harvested from right chest and was transposed 180 degrees clockwise in a propeller fashion to the left mastectomy defect without any tension. The flap survived without any complication and the patient was free of recurrence or metastases during the follow-up of 18 months. The patient was satisfied with the outcome. IMAP propeller flap could be harvested safely to the anterior axillary fold in the subcutaneous fat plane. It may provide a large skin paddle especially in large breasted women. © 2016 Wiley Periodicals, Inc. Microsurgery 36:507-510, 2016.

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“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] The principal indications for chest wall reconstruction are tumor (primary or recurrent), 5 infection, radiation injury, and trauma, and the particularly unfortunate patient may have any combination of the above. 23 A thorough knowledge of anatomy is the foundation for a clear operative plan and fallback procedure.…”

Section: Abstract: Chest Wall Reconstructionmentioning

confidence: 99%

“…9 The largest internal mammary artery perforators are reliably located in the second or third intercostal space and are the blood supply to the internal mammary artery perforator flap. [10][11][12] The largest angiosome in the torso is supplied by the posterior intercostal arteries. 13 Kerrigan and Daniel described cutaneous flaps based on the intercostal arteries.…”

Section: Vasculaturementioning

confidence: 99%

Introduction to Chest Wall Reconstruction: Anatomy and Physiology of the Chest and Indications for Chest Wall Reconstruction

Clemens

Evans

Mardini

et al. 2011

Seminars in Plastic Surgery

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The chest wall functions as a protective cage around the vital organs of the body, and significant disruption of its structure can have dire respiratory and circulatory consequences. The past several decades have seen a marked improvement in the management and reconstruction of complex chest wall defects. Widespread acceptance of muscle and musculocutaneous flaps such as the latissimus dorsi, pectoralis major, serratus anterior, and rectus abdominis has led to a sharp decrease in infections and mortality. Successful reconstructions are dependent upon a detailed knowledge of the functional anatomy and blood supply of the chest and the underlying pathophysiology of a particular disease process. This article will provide an overview of key principles and evidence-based approaches to chest wall reconstruction. KEYWORDS: Chest wall reconstructionThe complex interplay of 12 paired ribs with the internal and external muscles that compose the chest wall has both a structural and a functional role. The chest wall protects the heart, lungs, and liver, provides a flexible skeletal framework to stabilize the actions of the shoulder and arm, and promotes respiratory movement all while reliably delivering more than 20,000 breaths a day. Chest wall dysfunction is associated with significant morbidity and rapid life-threatening consequences. Management and reconstruction of complex chest wall defects has significantly improved over the past half century with long-term success rates improved from 50% to the current 90 to 99% and hospital stays reduced from an average of 84 days to less than 13 days. 1-6 A focus on anatomy and blood supply has led to the development of muscle and musculocutaneous flaps and the expanded use of prosthetic materials where appropriate. Knowledge of the functional anatomy and pathophysiology of the chest is essential to the success of the reconstructive chest surgeon. This article focuses on chest anatomy and function, with emphasis on the indications and essential principles of chest wall reconstruction.The study of the thoracic wall and its muscles, vessels, and nerves has been significantly advanced since the end of the past century by anatomic data and classification. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] The principal indications for chest wall reconstruction are tumor (primary or recurrent), 5 infection, radiation injury, and trauma, and the particularly unfortunate patient may have any combination of the above. 23 A thorough knowledge of anatomy is the foundation for a clear operative plan and fallback procedure. We will review the important anatomic considerations that are required for normal chest wall function. RELEVANT CHEST WALL ANATOMY SkeletonThe skeleton of the thoracic wall is formed by the spinal column and 12 thoracic vertebrae posteriorly, the sternum anteriorly, and bounded by 12 paired ribs and costal cartilages (Fig. 1). 7 Within the anterior thorax, the first seven pairs of ribs are attached to the sternum, the 8th through 10th ribs are attached t...

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Three- and Four-Dimensional Arterial and Venous Perforasomes of the Internal Mammary Artery Perforator Flap

Cited by 59 publications

References 15 publications

Freestyle Pedicle Perforator Flaps: Clinical Results and Vascular Anatomy

Freestyle Pedicle Perforator Flaps: Clinical Results and Vascular Anatomy

Internal mammary artery perforator propeller flap for contralateral mastectomy defect: A case report

Introduction to Chest Wall Reconstruction: Anatomy and Physiology of the Chest and Indications for Chest Wall Reconstruction

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