[Anatomy and clinical application of transcervicothoracic polyphyletic blood supply skin flap]

Transcervicothoracic skin flap was used to repair the faciocervical scars left after burns in 56 cases. Anatomy and clinical application proved that the transverse cervical artery branches out a constant skin artery before it enters the trapezius muscle and this artery, after crossing the clavicle, is divided into two branches, one extending outwards, and the other downwards. The internal thoracic artery branched out an intercostal perforator on the spot 1 cm to the parasternum. The perforator extended along the intercostal plane and belonged to the direct skin artery. The rate for perforation between the second and third ribs was the highest and the diameter of the perforator the greatest. The thoracoacromial skin artery perforated through the medialsemis between the greater pectoral muscle and the deltoid muscle, and extended toward the shoulder, supplying the skin of the infraclavicular, deltoid and upper greater pectoral regions with blood. Anatomy and contrast examination showed that there are extensive anastomoses between the three groups of blood vessels. On the basis of these anastomotic branches, transregional skin flaps can be designed to repair faciocervical damages. These flaps were successfully used in the 56 cases, with 32 cases having the the branch of cervical segment of the trasverse cervical artery as the pedicle, and 24, the second and third perforators of the internal thoracic artery as the pedicle. It was proved that the transregional flaps can be successfully transferred regardless of the sites of the pedicles.