Anatomical study of the perforator flap based on the acromial branch of the thoraco-acromial artery (abTAA flap): a cadaveric study.

Abstract

The aim of this anatomical study was to describe a local perforator flap, for covering shoulder defects, by determining the features of the acromial branch of the thoraco-acromial artery (abTAA), and the supplied cutaneous area. Thirteen fresh cadaveric thoraxes were dissected bilaterally. A precise and reproducible protocol was performed. For each abTAA flap cadaveric dissection, the following parameters were measured after arterial injection: distances between the origin of the perforator artery on the abTAA and the sternum, the acromion, the clavicle, diameter of the perforator artery of the abTAA, length of the perforator pedicle course through major pectoralis muscle, and rotation arc. We also calculated the surface of the injected skin paddle. These measurements were related to morphometric parameters evaluated through the distance between sternum and acromion. The mean distances measured from the origin of the perforator artery on the abTAA were 14.25cm to the sternum, 3.45cm to the acromion, 5.65cm to the clavicle. The mean diameter of the abTAA was 1.20mm ± 0.2. The arc of rotation was 180°, and the length of the perforator pedicle could be extended to 7.46cm ± 1.15. We observed an colored elliptical cutaneous paddle with a longer radius 18cm and a small radius 15cm. Our results suggest that this type of flap could be useful in clinical practice for reconstruction and covering of the acromial area with a thin cutaneous flap with low sequelae on the donor site.