The arterial anatomy of the saphenous flap: a cadaveric study

• Autorzy: Gocmen-Mas N. , Aksu F. , Edizer M. , Magden O. , Tayfur V. , Seyhan T.
• Języki publikacji: EN

Abstrakty

EN

The saphenous flap is a fasciocutaneous flap generally used for knee and upper third of the leg coverage. Due to various descriptions of the saphenous flap, such as venous, sensory, and free flap, the origin and distributing characteristics of the saphenous artery are important for plastic surgeons. The aim of this cadaveric study was to evaluate the anatomical features of the saphenous flap. The pedicles of the saphenous flap were dissected under 4 x loop magnification in thirty-two legs of 16 formalin-fixed adult cadavers. The findings of this anatomic study were as follows: Descending genicular artery originated from the femoral artery in all of the cases. The first musculoarticular branch, which arose from descending genicular, to the vastus medialis muscle existed in all dissections. The second branch was the saphenous artery which seperately originated from the descending genicular artery in all of the cases. At the level of origin the mean diameter of the saphenous artery was found to be 1.61 mm. The muscular branches to the anterior or posterior sides of the sartorious muscle existed in all of the dissections. Two vena comitantes and a saphenous nerve were accompanying the saphenous artery in all cadavers. The mean distance between the origin of the artery and interepicondylar line of tibia was 115 mm. The muscular branches of the saphenous artery to the gracilis muscle were encountered 6.66% of the cases. The cutaneous branches numbered between one and four, and arose 3.5 to 9.5 cm from the site of origin of the saphenous artery. The distal end of the saphenous artery reached approximately 122 mm distally to the knee joint in all cases. Due to variations of the arterial anatomy and limited number of anatomic studies of the saphenous flap, we studied the topography and anatomy of the saphenous artery for increasing reliability of the saphenous flap. (Folia Morphol 2012; 71, 1: 10–14)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2012
• Tom: 71
• Numer: 1
• Opis fizyczny: p.10-14,fig.,ref.

Twórcy

autor

Gocmen-Mas N.

• Dokuz Eylul University, School of Medicine, Department of Anatomy, Izmir, 03200 Afyonkarahisar, Turkey

autor

Aksu F.

• Dokuz Eylul University, School of Medicine, Department of Anatomy, Izmir, 03200 Afyonkarahisar, Turkey

autor

Edizer M.

• Dokuz Eylul University, School of Medicine, Department of Anatomy, Izmir, 03200 Afyonkarahisar, Turkey

autor

Magden O.

• Dokuz Eylul University, School of Medicine, Department of Anatomy, Izmir, 03200 Afyonkarahisar, Turkey

autor

Tayfur V.

• Ondokuz Mayis University School of Medicine, Plastic and Reconstructive Surgery, Samsun, Turkey

autor

Seyhan T.

• Baskent University School of Medicine, Plastic and Reconstructive Surgery, Ankara, Turkey

Bibliografia

• 1. Acland RD, Schusterman M, Godina M, Eder E, Taylor GI, Carlisle I (1981) The saphenous neurovascular free flap. Plast Reconstr Surg, 67: 763–774.
• 2. Cormac GC, Lamberty GBH eds. (1994) Saphenous artery flap 7. 2nd Ed. Churchill-Livinstone, New York, pp: 428–430.
• 3. Strauch B, Vasconez LO, Hall-Findlay EJ eds. (1998) Grabb’s encylopedia of flaps. 2nd Ed. Chapter 44. Lippincott-Raven, Philadelphia, pp.453–458.
• 4. Guan WS, Jin YT, Huang WY, Shi YM, Quian YL, Chang TS (1985) Experiences in the clinical use of the medial genicular flap. J Reconstr Microsurg, 1: 233–240.
• 5. Heymans O, Verhelle N, Peters S (2005) The medial adiposofascial flap of the leg: anatomical basis and clinical applications. Plast Reconstr Surg, 115: 793–801.
• 6. Karamürsel S, Celebioglu S (2006) Use of the medial side of the knee skin as a free flap: saphenous flap. Plast Reconstr Surg, 117: 1308–1314.
• 7. Koshima I, Endou T, Soeda S, Yamasaki M (1988) The free or pedicled saphenous flap. Ann Plast Surg, 21: 369–374.
• 8. Kostolich M, Pavletic MM (1987) Axial pattern flap based on the genicular branch of the saphenous artery in the dog. Vet Surg, 16: 217–222.
• 9. Mathes SJ, Nahai F (1981) Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg, 67: 177–187.
• 10. Matsumoto S, Ikeda A (1990). Comparative anatomy of the arterial system of the foot in primates: 1. Macaque. Acta Anat (Basel) 137: 367–372.
• 11. Mc Carty JG (1990) Plastic surgery. Vol. 3. Saunders Company, Philadelphia, pp. 4870–4871.
• 12. Nenad T, Reiner W, Michael S, Reinhard H, Hans H (2010) Saphenous perforator flap for reconstructive surgery in the lower leg and the foot: a clinical study of 50 patients with posttraumatic osteomyelitis. J Trauma, 68: 1200–1207.
• 13. Ostrovski NV, Alimov VK (1989) Topographic and anatomical substantiation of variants of the “saphenous” flap formation. Klin Khir, 1: 20–21.
• 14. Rao VK, Morrison WA, Angus JA, O’Brien BM (1983) Comparison of vascular hemodynamics in experimental models of microvascular anastomoses. Plast Reconstr Surg, 71: 241–247.
• 15. Regnard PJ, Bensa P, Zilliox R (1990) The saphenous flap called the Acland’s flap. Report of 2 cases Ann Chir Plast Esthet, 35: 313–316.
• 16. Sahin B, Uzun A, Emirzeoglu M, Kosif R, Bilgic S (2003) A deep femoral artery passing in front of the femoral vein. Folia Morphol, 62: 143–146.
• 17. Scheibel MT, Schmidt W, Thomas M, Von-Salis-Saglio G (2002) A detailed anatomical description of the subvastus region and its clinical relevance for the subvastus approach in total knee arthroplasty. Surg Radiol Anat, 24: 6–12.
• 18. Suder E, Nizankowski C (1985) Variations in the origin of the deep femoral arteries in human fetuses. Folia Morphol, 44: 262–269.
• 19 Torii S, Hayashi Y, Hasegawa M, Sugiura S (1989) Reverse flow saphenous island flap in the patient with below-knee amputation. Br J Plast Surg, 42: 517–520.