ABSTRACT: OBJECTIVE To investigate the application of pedicled internal mammary artery perforator (IMAP) flap for tracheostoma and anterior cervical defect.
From April to December 2009, 4 IMAP flaps, based on the second internal mammary artery perforator, were used for two cases of tracheostoma and two cases of anterior cervical skin defect. The flap size was (4-7) cm x (10-13) cm.
3 of 4 flaps survived completely. Partial necrosis happened in one flap. The defects at donor sites were closed directly.
The IMAP flap is a new method for head and neck defect. It is very suitable for tracheostoma and cervical skin defect, with less morbidity at donor site.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 01/2011; 27(1):12-4.
ABSTRACT: To study the anatomy of the anterolateral thigh perforators flap and explore its clinical application in the reconstruction of head and neck defects.
Five adult fresh cadavers were prepared, and morphosis and blood supply of anterolateral thigh flap perforators were examined by microsurgery anatomy. During dissections, the following parameters were recorded: number and type of perforators vessels, diameter of perforators, pedicle length, diameter of the original vessels, route (infra fascia and supra fascia); its position were located by anatomical landmark.
There were an average of (4.4 +/- 1.8) anterolateral thigh perforators flaps (ALTP flap) in each specimen with 68.2% musculocutaneous perforator and 31.8% septocutaneous perforator. The mean pedicle length of the largest perforator was (10.86 +/- 1.18) cm (8.29-14.44) cm, and its location was constantly concentrated in the superolateral region of the midpoint of the line linking the anterosuperior iliac spine and superolateral border of the patella. The distance between surface location of the largest perforator and the midpoint was (3.25 +/- 0.69) cm. Original vessel was mostly descend branch of lateral circumflex femoral artery/vein with average diameter of (3.16 +/- 0.59) / (3.08 +/- 0.02) mm.
ALTP flap has constant position, large caliber, and long pedicle and therefore is useful for operation and option in reconstruction of head neck defects.
Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 02/2010; 32(1):81-4.
ABSTRACT: To study the anatomy of internal mammary artery perforator (IMAP) flap.
Five fresh cadavers were used, the morphology and blood supply of IMAP flap were examined by the method of microsurgical anatomy. During dissections, following parameters were recorded: number, type and diameter of perforators vessels, course (infra fascia and supra fascia) and location of perforators vessels.
All 1st-4th IMAPs were found in 10 specimen. Average diameter of 1st-4th IMAP artery/vein was as follows (x +/- s): (1.29 +/- 0.28) mm, (1.46 +/- 0.22) mm; (1.1 +/- 0.27) mm, (1.41 +/- 0.39) mm; (0.87 +/- 0.23) mm, (1.17 +/- 0.15) mm; (0.92 +/- 0.22) mm, (1.12 +/- 0.14) mm. The largest perforator was mostly first or second IMAP. The angiosomal territory of IMAPs extended from the clavicle superiorly to the xiphisternum inferiorly, from the midline medially to anterior axillary fold laterally.
IMAP flap offers an option in reconstruction of head neck defects and should be considered as an alternative to the deltopectoral flap and pectoralis major flap in some patients.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 06/2009; 44(6):486-9.