Investigation of the dorsolateral branch of the posterior intercostal artery for use as the pedicle of a free flap: A cadaveric study and case series

Nam, Su Bong; Seo, Jung Yeol; Park, Tae Seo; Sung, Ji Yoon; Kim, Joo Hyoung; Lee, Jae Woo; Kim, Min Wook; Oh, Heung Chan

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자료유형: 학술저널

저자정보: Nam, Su Bong (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Seo, Jung Yeol (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Park, Tae Seo (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Sung, Ji Yoon (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Kim, Joo Hyoung (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Lee, Jae Woo (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Kim, Min Wook (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) Oh, Heung Chan (UP Plastic Surgery Clinic)

저널정보: 대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제46권 제1호

발행연도: 2019.1

수록면: 39 - 45 (7page)

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Background The dorsolateral branch of the posterior intercostal artery (DLBPI) can be easily found while harvesting a latissimus dorsi (LD) musculocutaneous flap for breast reconstruction. However, it remains unknown whether this branch can be used for a free flap and whether this branch alone can provide perfusion to the skin. We examined whether the DLBPI could be reliably found and whether it could provide sufficient perfusion. Methods We dissected 10 fresh cadavers and counted DLBPIs with a diameter larger than 2 mm. For each DLBPI, the following parameters were measured: distance from the lateral margin of the LD muscle, level of the intercostal space, distance from the spinal process, and distance from the inferior angle of the scapula. Results The DLBPI was easily found in all cadavers and was reliably located in the specified area. The average number of DLBPIs was 1.65. They were located between the seventh and eleventh intercostal spaces. The average length of the DLBPI between the intercostal space and the LD muscle was 4.82 cm. To assess the perfusion of the DLBPIs, a lead oxide mixture was injected through the branch and observed using X-rays, and it showed good perfusion. Conclusions The DLBPI can be used as a pedicle in free flaps for small defects. DLBPI flaps have some limitations, such as a short pedicle. However, an advantage of this branch is that it can be reliably located through simple dissection. For women, it has the advantage of concealing the donor scar underneath the bra band.

#Surgical flaps #Free tissue flaps #Reconstructive surgical procedures #Cadaver

참고문헌 (9)

참고문헌 신청

Fatah F / 1999 / Extended latissimus dorsi flap in breast reconstruction / Oper Tech Plast Reconstr Surg 6:38~49

Menke H / 2001 / Evolving concepts in breast reconstruction with latissimus dorsi flaps : results and follow-up of 121 consecutive patients / Ann Plast Surg 47:107~114

Chang DW / 2002 / Autologous breast reconstruction with the extended latissimus dorsi flap / Plast Reconstr Surg 110:751~759

Hamdi M / 2006 / The versatility of the inter-costal artery perforator(ICAP)flaps / J Plast Reconstr Aesthet Surg 59:644~652

Prasad V / 2012 / Dorsolateral musculocutaneous perforators of posterior intercostal artery : an anatomical study / J Plast Reconstr Aesthet Surg 65:1518~1524

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