Pan WR, Taylor GI, et al.
Plastic and reconstructive surgery. Date of publication 2009 Jan 1;volume 123(1):236-249.
1. Plast Reconstr Surg. 2009 Jan;123(1):236-249. doi: 10.1097/PRS.0b013e3181934873.
The angiosomes of the thigh and buttock.
Pan WR(1), Taylor GI.
Author information:
(1)Melbourne, Victoria, Australia From the Jack Brockhoff Reconstructive Plastic
Surgery Research Unit, Department of Anatomy and Cell Biology, University of
Melbourne.
BACKGROUND: The angiosomes of the body were defined in 1987. The recent
popularity of skin perforator and muscle flaps designed in the thigh, together
with significant major vessel anomaly and disease, has necessitated a more
detailed reevaluation of the blood supply to this region.
METHODS: Eighteen new studies, combined with a review of 36 of the authors'
archival studies of the buttock and the thigh, have been conducted in fresh human
cadavers using arterial perfusion with a radiographic lead oxide mixture.
RESULTS: The angiosome territories of the lumbar, deep circumflex iliac, sacral,
gluteal, common femoral, superficial femoral, lateral femoral circumflex, medial
femoral circumflex, profunda, descending genicular, and popliteal source vessels
that contribute to the thigh and buttock were defined between the skin and the
bone. The dominant cutaneous supply of perforators of 0.5 mm or greater emerged
from the deep fascia predominantly in longitudinal rows from the intermuscular
septa or from intramuscular septa, especially from the buttock muscles. Each
muscle was supplied from two or more angiosomes, thereby constituting important
bypass shunts for potential major vessel injury or disease, by means of their
intramuscular anastomoses.
CONCLUSIONS: These results may help the surgeon in the design of skin perforator
and refined muscle, musculocutaneous, and composite flaps in the thigh and the
buttock. The study also provides for a better understanding of vessel anastomoses
in the region.
DOI: 10.1097/PRS.0b013e3181934873
PMID: 19116558 [Indexed for MEDLINE]
