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Fascicle Arrangement in Skeletal Muscles

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Related Experiment Video

Updated: Jun 23, 2026

The Superficial Inferior Epigastric Artery Fascia Flap for Nerve Reconstruction in Rabbits

The Superficial Inferior Epigastric Artery Fascia Flap for Nerve Reconstruction in Rabbits

Published on: June 13, 2025

Fascicular turnover flap for nerve gaps.

Isao Koshima¹, Mitsunaga Narushima, Makoto Mihara

¹Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. koushimai-pla@h.u-tokyo.ac.jp

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS

|April 28, 2009

Summary

The fascicular turnover method offers a simpler, faster surgical alternative for nerve gap repair, promoting rapid axonal sprouting without sacrificing donor nerve function. This vascularised nerve flap technique shows excellent regeneration potential, even in challenging cases.

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Engineered Vascularized Muscle Flap

Engineered Vascularized Muscle Flap

Published on: January 11, 2016

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Last Updated: Jun 23, 2026

The Superficial Inferior Epigastric Artery Fascia Flap for Nerve Reconstruction in Rabbits

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Published on: June 13, 2025

Engineered Vascularized Muscle Flap

Engineered Vascularized Muscle Flap

Published on: January 11, 2016

Area of Science:

Regenerative Medicine
Microsurgery
Neuroscience

Background:

Free vascularised nerve grafts offer rapid axonal sprouting but are complex surgically.
Advancements in microsurgical techniques and nerve trunk microanatomy enable new methods like the fascicular turnover method.
This technique utilizes a vascularised fascicular flap for nerve gap repair, avoiding traditional nerve grafts.

Observation:

Arterial embalming of rat sciatic nerves revealed rich intra- and extra-fascicular vascular networks in island nerve flaps.
The fascicular turnover method was applied to four patients with digital and facial nerve gaps (10-20mm and 3cm, respectively).

Findings:

Patients with digital nerve gaps achieved sensory recovery scores of 3.22-3.66 (Semmes-Weinstein) and 6-12mm (two-point discrimination) at 6-16 months post-surgery.
The fascicular turnover flap demonstrated fast and accurate nerve sprouting compared to non-vascularised grafts.
The method allows for repair under local anesthesia, with shorter operation times and no functional loss of the donor nerve.

Implications:

The fascicular turnover method presents a simpler, quicker surgical option than free vascularised nerve flaps.
It offers excellent nerve regeneration potential, suitable for longer nerve gaps and scarred recipient beds.
The primary limitation is the requirement for advanced microsurgical skills using fine needles (50-micron).