Anatomical Basis Of The Hairy Perforator Flap

Objective:To explore the morphological features of perforating vessels in the hairy area,and to provide anatomic basis for the design of the hairy perforator flap.Method:30 specimens of adult cadaver(18 male,12 female)were fixed by 10% formaldehyde conventionally and 2 specimens of fresh adult cadaver(female),followed by managements of red latex artery perfusion,perchloroethylene vascular casting,microscopic anatomy,and mimic operation.The origin,course,branch and vascular anastomosis of the perforators in axillary,mons pubis and temporoparietal area were observed.The outer diameter and length as well as other related data of each perforator were measured and analyzed.Results:The hairy area that could be designed as hairy perforator flaps are mainly axillary area,mons pubis area and temporoparietal area.There were three types of perforating vessels in the bottom of the axillary area: the first cutaneous branch of the thoracodorsal artery(96.7%),the first cutaneous branch of the lateral thoracic artery(90%),and the cutaneous branch of the axillary artery(93.3%),with an average original outer diameter of(1.2±0.3)mm,(1.2±0.2)mm,and(1.4±0.3)mm,respectively.The pubic hair area was mostly supported by the superficial external pubic artery,which originated from the femoral artery and bifurcated into the superior and inferior branches at the end of the great saphenous vein,with an average original outer diameter of(1.2±0.2)mm and(1.1±0.3)mm,respectively.The skin in the temporoparietal area was mainly supported by the perforator of the superficial temporal artery.After originating from the external carotid artery,the superficial temporal artery bifurcated into the frontal and parietal branches at about 2~3cm above the tragus.The frontal branch distributed in the frontal-parietal and frontal-orbital region with an original outer diameter of(1.7 ± 0.3)mm,while the parietal branch distributed in the temporoparietal region and the calvaria with an original outer diameter of(1.6 ± 0.2)mm.Conclusion:The skin of the axillary,mons pubis and temporoparietal area are abundant in blood supply,which has constant anatomy.At least one skin perforator can be selected as the vascular pedicle to design a hairy perforator flap in the area mentioned above,so as to repair the hairy skin defect caused by tumor radical operation,burns,trauma and other reasons.