Youyi Jiang1,2, Maochao Ding3, Zhengbing Zhou1, Juyu Tang4, Panfeng Wu1, Fang Yu1, Wei Du1, Yihua Mao3, Fengjuan Kong2, Maolin Tang5. 1. Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China. 2. Department of Hand Surgery, Song Qingling Caring Hospital, Chaohu, 238000, Anhui, China. 3. Department of Anatomy, Institute of Clinical Applied Anatomy, School of Basic Medical Sciences, Basic Medical College, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China. 4. Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China. tangjuyu7749@163.com. 5. Department of Anatomy, Institute of Clinical Applied Anatomy, School of Basic Medical Sciences, Basic Medical College, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China. mltang001@hotmail.com.
Abstract
BACKGROUND: The acromial arterial rete (AAR) is the junction between the skin blood supply of the cervical side and that of the upper arm, and it is the only site crossed by the trans-regional blood supply of the cervico-humeral flap (CHF). The aim of this study was to explore the structures of AAR to optimizing flap design. METHODS: A body arteriography and spiral CT scan were performed on 33 whole adult corpses. The 3D reconstruction was used to perform continuous digital layered anatomy of the shoulder and upper chest; the acromion and acromioclavicular joint were used as the center to observe the source, route and distribution characteristics of a perforating branch and their anastomosis. RESULTS: The perforating branches were separated from an acromial branch of the transverse cervical artery (97%), posterior humeral circumflex artery (95%), a deltoid branch of the thoracoacromial artery (95%), and the acromial branch of the thoracoacromial artery (93%). The diameter of the acromial branch of the transverse cervical artery at its initial location was 1.18 ± 0.37 mm; the trunk length was 12.53 ± 3.83 cm, and it was anastomosed with other blood vessels in three forms. CONCLUSION: Deep fascia should be included in the flap design. Three kinds of pedicled transfer flaps can be designed with the acromial branch of transverse carotid artery as the vascular pedicle. Free flaps can be designed with the acromial branch of thoracoacromial artery as the vascular pedicle.
BACKGROUND: The acromial arterial rete (AAR) is the junction between the skin blood supply of the cervical side and that of the upper arm, and it is the only site crossed by the trans-regional blood supply of the cervico-humeral flap (CHF). The aim of this study was to explore the structures of AAR to optimizing flap design. METHODS: A body arteriography and spiral CT scan were performed on 33 whole adult corpses. The 3D reconstruction was used to perform continuous digital layered anatomy of the shoulder and upper chest; the acromion and acromioclavicular joint were used as the center to observe the source, route and distribution characteristics of a perforating branch and their anastomosis. RESULTS: The perforating branches were separated from an acromial branch of the transverse cervical artery (97%), posterior humeral circumflex artery (95%), a deltoid branch of the thoracoacromial artery (95%), and the acromial branch of the thoracoacromial artery (93%). The diameter of the acromial branch of the transverse cervical artery at its initial location was 1.18 ± 0.37 mm; the trunk length was 12.53 ± 3.83 cm, and it was anastomosed with other blood vessels in three forms. CONCLUSION: Deep fascia should be included in the flap design. Three kinds of pedicled transfer flaps can be designed with the acromial branch of transverse carotid artery as the vascular pedicle. Free flaps can be designed with the acromial branch of thoracoacromial artery as the vascular pedicle.
Entities:
Keywords:
3D visualization; Acromial arterial rete; Angiography; Cervico-humeral flap; Plastic surgery
Authors: Jennifer W H Chan; Corrine Wong; Kenneth Ward; Michel Saint-Cyr; Ernest S Chiu Journal: Plast Reconstr Surg Date: 2010-02 Impact factor: 4.730
Authors: Jay W Granzow; Ahmed Suliman; Jason Roostaeian; Adam Perry; J Brian Boyd Journal: Otolaryngol Head Neck Surg Date: 2013-04-03 Impact factor: 3.497
Authors: Jay W Granzow; Ahmed Suliman; Jason Roostaeian; Adam Perry; J Brian Boyd Journal: Otolaryngol Head Neck Surg Date: 2013-04-03 Impact factor: 3.497