Anatomical study on arteries of fasciae in the forearm fasciocutaneous flap.

The arteries of the forearm flap were studied systematically and quantitatively to determine the survival mechanism of fasciocutaneous flaps and provide morphological basis for clinical application. Fourteen forearms from fresh adult cadavers were investigated by methods of dissection under operating and biological microscopes, tissue clearing, tissue sectioning, and image analysis. There were four arterial types in the forearm flaps in which the intermuscular space cutaneous artery was predominant in number. Both intermuscular space cutaneous arteries and intermuscular septal cutaneous arteries anastomosed by branches as arterial chains along the intermuscular spaces and septa where the stem arteries ran through. Arteries of each type gave off epi- and subfascial branches to the deep fascia, and the former were greater in number and larger in diameter. In the same way, the vascular network was thicker in the epifascial level than that in the subfascial level. The percentage of the area of blood vessels in deep fascia (Aa%) was larger than that of the superficial fascia. In the forearm, the deep fascial vasculature is the main pathway through which the fasciocutaneous flap gains its blood supply, and the epifascial vascular network is especially important. It would be better to select the fascial pedicle where the arterial chain exists. Copyright 2000 Wiley-Liss, Inc.