OBJECTIVEObserve the course,distribution and variation of inferior gluteal artery to provide an anatomic basis.

METHODS18 specimen (11 male and 7 female. 9 left and 9 right) were perfused with red latex to show inferior gluteal arteries and the tissue around them.

RESULTSUsually inferior gluteal artery travels through infrapiriform foramen and goes down along ischiadicus nerve. It gives three main branches as ramus of articularis, ramus of ischiadicus, ramus of muscularis at average distances of 17.3 mm, 33.2 mm and 51.8 mm to infrapiriform foramen and nourishes them respectively. However, variation was found in 7 of 18 specimen (5 are female) .

CONCLUSIONSThe course of inferior gluteal artery is steady in most cases, but sometimes variation can be found. Special examinations such as colour Doppler ultrasound are suggested to find the course of inferior gluteal artery on the whole level before operation.

Arteries ; anatomy & histology ; Buttocks ; blood supply ; Female ; Humans ; Male ; Pelvis ; blood supply ; Surgical Flaps ; blood supply

OBJECTIVETo evaluate the effect of wound closure tension on the blood flow of the expanded pedicled fasciocutaneous flap, so as to find the best tension for the blood supply of the flap.

METHODS8 piglets, aged 9-12 months, were used. On each side of pig back, a cephalic based expanded fasciocutaneous flap was designed. The size of the flaps was 5 cm x 20 cm. In the control group, the flaps were not elevated (0 g tension). In the experimental group, the flaps were treated at the end with the tension of 100, 200, 300, 400, 500, 600, 700, 800, and 900 g after elevation. The blood oxygen saturation (StO2) of the flaps was measured under different wound closure tension.

RESULTSThe flap StO2 raised along the increase of tension until the tension reached 200-300 g. Then the flap StO2 decreased when the tension continued to increase above 200-300 g.

CONCLUSIONSThe tension of 200-300 g is good for the blood flow of expanded pedicled fasciocutaneous flap. So the flap flexibility can be best used and the complication can be avoided.

Animals ; Surgical Flaps ; blood supply ; Sus scrofa ; Swine ; Tensile Strength

OBJECTIVETo study a new method of venous flap that is improved on its persistence and quality.

METHODSNew Zealand white rabbits were subdivided randomly into 4 groups. All rabbits were operated by harvesting a flap from the latero-abdominal wall and then sutured it in the original position. Group A: the superficial epigastric vein in the pedicle was left open (only one inflow vein remained). Group B: the pedicle vein of the proximal and distant end were left open (keeping an inflow vein and a principal out). Group C: the pedicle vein and a tributary vein were left open (keeping an inflow vein and a tributary outflow vein). Group D: the pedicle vein and two tributary veins were left open (keeping an inflow vein and two tributary outflow veins). Survival rate, MDA of the tissue, histology and ultra-microstructure were examined.

RESULTSSurvival rate of A, B, C, D were improved in order. Statistic difference is significant (P < 0.05) between group and group other than C and D. The content of MDA was heightened with statistically significant differences (A > B > C > D) among the four groups 8 hours postoperatively, but fell back to the normal level in group D and C and kept a high level in group A and B at 72 hour postoperatively. Histology and ultra-microstructure exam showed that degeneration of collagen fiber and karyopyknosis of cell is more obvious in Group A and Group B than Group C and Group D.

CONCLUSIONSThe higher survival rate of venous flap is possible by designing the more reasonable venous flap outputs pedicles which can alleviate the high tension dropsy and maintain the valid equilibrium of pour with flow in the venous flap.

Animals ; Graft Survival ; Rabbits ; Surgical Flaps ; blood supply ; Veins ; transplantation

OBJECTIVETo present the operation for nose defect reconstruction using a retroauricular free flap and the auricle cartilage.

METHODSBased on the anatomy and blood supply of the retroauricular region, a flap was designed and harvested with the posterior auricular vessels as its pedicle. The flap was used to repair nose defects in five patients. Of them, three had unilateral subtotal alinasal defects, one had nasal apex defect, and one had defects on nasal apex and bilateral ala. The size of the defect ranged from 2.5 cm x 1.5 cm to 3.0 cm x 4.0 cm. The flap varied between 3.0 cm x 2.0 cm and 4.5 cm x 3.5 cm. In 4 cases, the auricular cartilage of 2.0 cm x 1.5 cm to 1.5 cm x 1.0 cm was taken along with the flap. The posterior auricular vessels were anastomosed with the facial vessels. The donor site was covered with full-thickness skin graft.

RESULTSPostoperatively, the blood supply to the flaps was fairly good in 3 cases, while there was various venous stasis in 2 cases during the first 4 days. However, the postoperative results of the 5 cases were satisfactory.

CONCLUSIONSThe retroauricular free flap is a good choice for partial nose reconstruction, which had the merits of well-hidden donor site, good color match, and one-stage operation.

Humans ; Nose ; abnormalities ; surgery ; Skin Transplantation ; Surgical Flaps ; blood supply

OBJECTIVEThe aim of the work was to study the change for blood pour into the artery fascial flap and oxygen metabolic in tissue that knew the process of the flap.

METHODSWe do the artery fascial flap in the rabbit, then measured the skin capillary blood flow and the content of the MDA.

RESULTSThe content of the MDA rise when the blood flow descends in the flap, but it lives well.

CONCLUSIONSThat the content of the MDA rise as time the blood flow descend in the flap is a gradual process of the whole flap from tip to end, the flap will not appear necrosis until the MDA reach a rather degree.

Animals ; Fascia ; Lipid Peroxidation ; Male ; Rabbits ; Surgical Flaps ; blood supply

OBJECTIVETo explore a new method for enlarging the rotation range of the nasolabial fold flap.

METHODSWe designed a retrograde nasolabial fold island flap pedicled with the upper lip artery for repairing facial defects. The anatomy of the upper lip and the vascular supply to the nasolabial skin were observed.

RESULTSAll the flaps in 7 cases survived completely with satisfactory results.

CONCLUSIONThe retrograde nasolabial fold island flap pedicled with the upper lip artery enlarged the rotating range of the nasolabial fold flap. The flap is recommendable for its consistent pedicle and abundant vascular supply.

Arteries ; Female ; Humans ; Lip ; blood supply ; Male ; Nose ; Surgical Flaps

OBJECTIVETo elucidate the reconstruction of neovascularization that occurred in the superiorly and inferiorly based posterior pharyngeal flaps in different time postoperatively.

METHODSTen mongrel dogs were randomly divided into two experimental groups, which were performed superiorly or inferiorly based posterior pharyngeal flap surgery respectively. Each group was then subdivided into five subgroups, and were sacrificed immediately after operation or on 3, 7, 30, 90 day postoperative respectively. Microangiography was used to exhibite the vessel.

RESULTS1. The blood vessel reconstruction of the superiorly based posterior pharyngeal flap was more rapid compared with the inferiorly based flap. The 3-day flap has established an axial vascular network, which was mature on the 30-day flap. The superiorly based posterior pharyngeal flap was mainly supplied by the pedicle. 2. The blood vessels reconstruction of the inferiorly based posterior pharyngeal flap was firstly occurred in the pedicle and apex of the flap, which grew slowly to the middle of the flap. The inferiorly based posterior pharyngeal flap was supplied by the pedicle and the soft palate. A mature axial vascular network was exhibited on the 90-day flap, which was not mature on the 30-day flap.

CONCLUSIONBoth superiorly and inferiorly based posterior pharyngeal flap can establish an axial vascular network and gain ample blood supply.

Animals ; Dogs ; Neovascularization, Physiologic ; Palate, Soft ; blood supply ; Pharynx ; blood supply ; Random Allocation ; Reconstructive Surgical Procedures ; Surgical Flaps ; blood supply

OBJECTIVETo investigate the vascular supply of intrinsic muscles of foot and anatomic basis for muscular flap design.

METHODSA radiopaque injectate (lead oxide-gelatin mixtures, 26 ml/kg) was injected into 10 fresh cadavers. The dissected regions were photographed and each intrinsic muscles on the foot was removed and radiographed. The number, type, diameter of vascular branches of muscles and their distributions were observed. The area of the vascular territory supplied by each source vessel was calculated using Scion Image for Windows software.

RESULTSThere were significant architectural differences among the intrinsic muscles. The muscles length varied from 22.5mm to 116.2mm [average, (66.1 +/- 23.2)mm]. The measured fiber length were relatively consistent, ranging from 14.2 mm to 27.5 mm [average, (20.2 +/- 4.5)mm]. There are 63 vascular branches into the 23 foot muscles, each muscle having average branches of 3.2 +/- 0.8. The average diameter of branches, the length and width of each vascular territorial area is (0.8 +/- 0.3) mm, (2.2 +/- 0.8) cm, and (0.9 +/- 0.4) cm, respectively. Other findings included that some muscles were not present in some cadavers.

CONCLUSIONSThe blood supply of intrinsic muscles of foot is abundant with different diameter and distributions of branches. There is an anatomic basis for muscular or musculoosseous flap design. There are 7 intrinsic muscles with large and reliable vascular supply which can be chosen as muscular flaps.

Adult ; Foot ; blood supply ; Humans ; Muscle, Skeletal ; blood supply ; Surgical Flaps

OBJECTIVETo investigate the microvascular structure of the transmidline scapular flap pedicled with the unilateral circumflex scapular artery.

METHODSLatex and ink mixture was injected into the unilateral circumflex scapular artery of 6 fresh cadavers. The transmidline scapular flap was dissected and the pellucid specimen was made. The artery perforators were traced to their underlying parent vessels that accompanied the segmental arteries. A series of cross-sectional studies were undertaken in one subject to illustrate the course of the perforators in the tissues of different depth.

RESULTSIn deep and superficial fascia, the subdermal and dermis layer, rich microvascular connection was found which showed in three patterns: the vascular arch, communicating branches, and the arterial rate. They interrelated to form a three-dimensional framework. The vascular tree not only passed the midline but also reached the contralateral acromion. The densest vessels were exhibited at the injection side of the back. In the midline area the vessels were in less density and at the contralateral side, the vessels mainly concentrated in the upper part of the back.

CONCLUSIONThe result evidenced the vascular pattern and the applicable safety of the transmidline scapular flap. In elevating a transmidline scapular flap, the distal part should mainly locate at the upper part of the back.

Adult ; Arteries ; anatomy & histology ; surgery ; Cadaver ; Humans ; Male ; Scapula ; blood supply ; Surgical Flaps ; blood supply

OBJECTIVEThe traditional gracilis musculocutaneous flap is supplied by a branch of deep femoral artery, which enters the muscle in between the upper and middle third of it. So the flap barely reaches the pelvis and perineum region for reconstruction. By exploring the blood supply pattern we tried to rotate the flap Upon at the higher point starting at the obturator foramen in order to let it cover a bigger area.

METHODSanatomical reviewing of the blood supply of the gracilis branches of obturator, medial femoral circumflex and deep femoral arteries. Based on this a new type of longitudinal gracilis musculocutaneous flap supported only by the obturator artery was designed to reach the pelvis, female genitalia, pubic symphysis, inguinal area easily.

RESULTSThe new kind of flap has been applied to 9 patients for deformity repairing and tissue replacement in the pelvic and perineal area. All the flaps survived and achieved satisfactory result with 3 months to 3 years' follow up.

CONCLUSIONSLongitudinal gracilis musculocutaneous flaps supplied by the obturator artery can be used as regular musculocutaneous flap clinically.

Female ; Femoral Artery ; surgery ; Humans ; Muscle, Skeletal ; blood supply ; transplantation ; Surgical Flaps ; blood supply