| Objective To investigate the feasibility of clinical application of the thoracodorsal artery musculocutaneous perforator flap(TAMPF). Methods (1)The morphosis and blood supply of TAP flap on 15 formolized adult cadavers(30 sides) using microsurgery anatomy were examined. (2) A imitative operation of the thoracodorsal artery musculocutaneous perforator flap(TAMPF) and latissimus dorsi flap on 1 formolized adult cadavers(2 sides) was conducted. (3)The musculocutaneous perforator on 15 adult living body(30 sides) was scaned by Doppler flowmeters, and its results were compared with the anatomic data. Results (1)The blood supply of latissmus dorsi and subcutaneous tissue was from various artery, such as: TA, musculocutaneous perforator, intercostal artery, lumbar artery and direct cutaneous artery, with TA and musculocutaneous perforator accountered for the most. (2)The neurovascular hilus was situated at 3.66cm(2.80cm ~ 4.80cm)over the plane of subscapular angle and 5.56cm(4.43cm~6.12cm) of the perpendicular line laterally of subscapular angle. (3) The external diameter of the medial branch vessel and the lateral branch was 1.14 +0.13 mm(0.93mm~ 1.42mm) and 1.12+ 0.11mm(0.86mm~ 1.36mm) repectively. (4)A total of 102 musculocutaneous perforators larger than 0.5mm were found in 16 specimens(32 sides). Fifty-six perforators(55%) were originated from the medial branch and 46(45%) originated from the lateral branch. The biggest perforator is 0.82 +0.11mm (0.68mm~ 1.08mm) .There was an average of 1.9 perforators(range,1~3 perforators) of the medial branch and an average of 1.8 perforators(range,l~3 perforators). Additionally, 24 perforators samller than 0.5mm were found, and there were 76 perforators originated from intercostal artery and lumbar artery. (5)Musculocutaneous perforators over 0.5mm were found only in proximity of the medial and lateral branches within a distance of8.5cm(6.4cm~9.2cm) distal to the neurovascular hilus. (6)A total of 184 perforators in adult living body were scanned by Doppler flowmeter. There was no difference between the anatomic data and scanned data. Conclusion With the characteristics of constancy, large caliber, long pedicle, the thoracodorsal artery musculocutaneous perforator was suitable for the making of musclocutaneous perforator flaps and "fan-shaped" flaps. |
