The clinical study of direct cutaneous artery flap of the upper thigh

Abstract

Objective To study the anatomic basis of direct cutaneous artery flap of the upper thigh and review the clinical outcome of its application. Methods The direct cutaneous arteries of the upper thigh were dissected in 20 sides of the adult embalmed cadaverie specimens perfused with red relax. The arteries were perfused with Chinese ink in 2 fresh cadaver specimens to observe the distribution area. During surgical harvesting of anterolateral femoral skin flap in 50 cases, the occurrence rate, source artery, diameter and course of the direct cutaneous arteries of the upper thigh were noted. Forty-two cases of soft tissue defects were repaired with direct cutaneous artery skin flap of the upper thigh. Results Direct cutaneous arteries of the upper thigh oecurred in 15 of 20 sides of the adult embalmed cadaveric specimens perfused with red relax. The occurrence rate thereof was 75.0%. The size of the flaps dyed with Chinese ink was 11.0 cm × 18.0 cm. The occurrence rate of direct cutaneous arteries during dissection of the 50 cases of anterolateral femoral skin flap was 72.0% (36 arteries in 36 cases). Direct cutaneous artery of the upper thigh came from the lateral femoral circumflex artery ( 56.9%, 29 sides), the deep femoral artery( 15.7%, 8 sides) or the femoral artery ( 27.4%, 14 sides ). The mean diameter of origin site. of these direct cutaneous arteries was (2.7 ±0.2) mm. Among the 42 cases of direct cutaneous artery skin flap of the upper thigh, 3 flaps survived with partical necrosis and healed after changing dressing or skin graft. The others survived completely, the size of flaps ranged from 6.0 cm × 8.0 cm to 11.1cm×18.0cm(11 free skim flaps andm 31 pedicle flaPS), Conclusion The direct eutaneous artery skin flap of the upper thigh has good blood supply and is easy to harvest. It can be made into not only pedicled flap but also free transplantable flaps. It is possible to harvest the flap without any muscle. The lateral femoral cutaneous nerve can be harvested and anastomosed with a cutaneous nerve of the recopient site. Key words: Surgical flaps; Hand injuries; Mierosurgery; Direct eutaneousarteries of superior thigh