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Two-Dimensional X-Ray Angiography to Examine Fine Vascular Structure Using a Silicone Rubber Injection Compound

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Hand Perforators: An Anatomical Study.

Murat S Alagoz¹, Ahmet C Uysal², Atakan Sahiner¹

¹From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Kocaeli University.

Plastic and Reconstructive Surgery

|March 14, 2025

Summary

Detailed hand perforator anatomy aids reconstructive surgery. Understanding these vessels allows for precise flap design, improving tissue compatibility and minimizing patient morbidity.

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Area of Science:

Anatomy
Microsurgery
Reconstructive Surgery

Background:

Perforator flaps are vital for reconstructing hand defects from tumors, trauma, or burns.
Knowledge of hand perforator anatomy enables defect-adjacent flap design, enhancing tissue compatibility and avoiding major artery sacrifice.

Purpose of the Study:

To detail the cutaneous perforator anatomy of the hand.
To provide anatomical data for optimizing perforator flap design in hand reconstruction.

Main Methods:

Dissection of radial and ulnar arteries in 22 formaldehyde-fixed cadaver hands.
Injection of dyed latex into arteries, followed by measurement and recording of skin perforator exit points.

Main Results:

Perforator vessels were consistently found in all examined palmar subregions.
Proximal hypothenar, distal thenar, and midpalmar regions showed a higher density of perforators suitable for flap design.
The dorsal hand, particularly the middle dorsum, exhibited the fewest perforators, with some hands lacking them in this area.

Conclusions:

This study provides a detailed anatomical map of hand cutaneous perforators.
Understanding hand perforator anatomy empowers surgeons to design optimal flaps for hand defects, maximizing surgical outcomes and minimizing complications.