Perforator patterns of the ulnar artery perforator flap

Area of Science:

• Microsurgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Ulnar artery perforator flaps offer potential advantages but are less popular than radial forearm flaps.
• This study details a true ulnar artery perforator flap technique with precise perforator mapping.

Purpose of the Study:

• To describe the ulnar artery perforator flap anatomy and surgical technique.
• To evaluate the flap's reliability and outcomes in head and neck reconstruction.
• To compare preoperative and postoperative grip strength.

Main Methods:

• Thirty-eight patients underwent ulnar artery perforator flap surgery.
• Intraoperative recording of perforator size, number, and location.
• Preoperative and postoperative grip strength assessment.

Main Results:

• Anatomical mapping identified 1-3 perforators (A, B, C) with consistent locations and presence rates (Perforator B: 95%, Perforator C: 87%, Perforator A: 79%).
• All patients had at least two perforators; 61% had three.
• All 38 flaps were successfully used for head and neck reconstruction with minor donor-site morbidity.
• Postoperative grip strength showed a transient decrease, with most patients recovering to baseline by 3 months.

Conclusions:

• The ulnar artery perforator flap territory consistently contains at least two perforators.
• This flap is reliable, easy to harvest, and associated with minimal donor-site morbidity.
• It represents a viable alternative to the radial forearm flap for select reconstructive cases.