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Related Experiment Videos

The thin circumflex scapular artery perforator flap.

J Dabernig1, K Sorensen, J Shaw-Dunn

  • 1Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|September 11, 2007
PubMed
Summary
This summary is machine-generated.

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Distal Brachial Artery Perforator flap: a new chimeric option for complex hand and digits defects.

Journal of plastic, reconstructive & aesthetic surgery : JPRAS·2021

A new thin perforator flap based on the circumflex scapular artery (CSA) minimizes donor site morbidity. This versatile flap offers high-quality skin for reconstructions with no intramuscular dissection, achieving excellent patient outcomes.

Area of Science:

  • Microsurgery
  • Plastic Surgery
  • Reconstructive Surgery

Background:

  • Perforator flaps aim to minimize donor site morbidity and avoid transferring unnecessary tissue.
  • Vascular basis of perforator flaps allows for primary thinning before transfer.
  • Need for versatile, thin flaps with minimal donor site impact in reconstructive surgery.

Observation:

  • Initial clinical, cadaveric, and radiological studies identified a perforator vessel near the circumflex scapular artery (CSA) bifurcation.
  • This perforator arises from the main trunk or descending branch of the CSA, within 1.5cm of its bifurcation.
  • The perforator vascularizes the dorsal scapular skin's sub-dermal plexus, enabling thin flap elevation.

Findings:

  • A new, thin perforator flap based on the circumflex scapular artery (CSA) was developed.

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  • The flap requires no intramuscular dissection, has a pedicle length of 8-10cm, and vessel diameter of 2-4mm.
  • Five clinical cases demonstrated successful reconstruction of axillary and upper limb defects (hidradenitis suppurativa, sarcoma, vascular reconstruction, hand reconstruction) with high patient satisfaction and no flap failure.

    • Implications:

    • The CSA perforator flap offers a promising alternative for reconstructive surgery, providing high-quality skin with customizable characteristics.
    • Its favorable donor site (hair-free, good cosmesis, no functional morbidity) and ease of elevation (no intramuscular dissection) enhance its utility.
    • This flap expands the armamentarium of perforator flaps, offering versatile reconstructive options for various defects.