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[Fasciocutaneous radial artery perforator vessels - an anatomic study]
C Heitmann1, F N Khan, L S Levin
1Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC, USA. Heitmann@duke.edu
Purpose/Background:
Distal and proximal pedicled forearm flaps that are nourished by radial perforator vessels have been described. These flaps spare the radial artery during flap harvest. The question is, whether it is possible to raise individual free fasciocutaneous radial perforator flaps.
Method And Material:
The number, external vessel diameter, and distribution of fasciocutaneous radial perforator vessels were investigated on 20 fresh cadaver arms. All specimen were then treated with the Spalteholz technique to demonstrate the arborizing of the perforator vessels.
Results:
There was an average of 12 (range 9 to 16) fasciocutaneous perforator vessels per radial artery. The most proximal perforator vessel had an external diameter of 0.8 (range 0.5 to 1.0) mm, the others were measured smaller then 0.5 mm. There was a rich network of anastomoses at the level of the fascia up to the level of the subdermal plexus.
Conclusions:
The anatomic basis of the proximally and distally based radial perforator flaps was confirmed. Free flaps based exclusively on fasciocutaneous radial perforators would require supra-microsurgical skills due to the small vessel diameter. For practical reason it seems to be advisable to include parts of the radial artery into such a flap design.