Vascular anatomy of the human integument: An analysis of potential donor sites for perforator skin flaps

Perforator flaps represent a new frontier in plastic and reconstructive surgery. Since their recent introduction in the late 1980s, the management of soft tissue defects in plastic surgery has been transformed. Surgeons are no longer bound by a limited number of vascularized soft tissue donor sites, but have the ability to customize flaps from many regions of the body. However, the true potential of perforator flaps has yet to be realized. This study focuses on the anatomical potential of perforator flaps by describing the vascular architecture of the integument and quantifying the distribution of the perforating vessels of principal source arteries supplying the skin.; In total there are an average of 442 +/- 121 significant perforators supplying the integument from 60 paired source arteries. Musculocutaneous perforators out-numbered septocutaneous perforators in a ratio of 3:2. Our results showed that there are many novel donor sites in the body suitable for perforator flap design. (Abstract shortened by UMI.)...