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2015 | 74 | 3 |
Tytuł artykułu

Significance of anatomical variations of the lateral circumflex femoral artery for the tensor fasciae latae flapping

Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
The tensor fasciae latae (TFL) muscle is commonly used in plastic and reconstructive surgery as a transpositional or a free flap, in order to repair different kinds of defects. In most cases its vascularisation is provided by an ascending branch of lateral circumflex femoral artery (LCFA), which gives different numbers of branches and enters the TFL muscle in different manners. The represented study deals with the arterial vascularisation of the TFL muscle: the entrance of the vascular stalk branches; variations of the LCFA bifurcation’s angle; and the skin area of vascularisation. The study was performed on both lower limbs of a 100 foetal and 10 adult cadavers. The LCFA was injected with micropaque solution, afterwards fixed and preserved in 10% formalin solution. Microdissection was performed under magnifying glass and surgical microscope. Analysis of adult cadavers was performed to determine the skin area vascularised by perforating blood vessels from the TFL muscle, by injecting methylene-blue dye into the artery, prior to which all branches of the LCFA, besides the ascending branch, were ligated. The research of a 100 foetal cadavers showed that the LCFA with its ascending branch ensured the blood supply to the muscle. In 85% it gave two branches, the ascending and the descending one, with the angle of bifurcation circa 90° in 73% of cases. The ascending branch can give 0 or more terminal branches, or even form an arterial net. Skin area affected with dye ranged from 18 × 22 cm to 23 × 28 cm and is in positive correlation with the LCFA length and diameter. The understanding of the presented variations have an exceptional significance in planning and applying the TFL flap, especially free flap, in successful repairing and covering the defects, as well as in preventing postoperative complications. (Folia Morphol 2015; 74, 3: 389–395)
Słowa kluczowe
Wydawca
-
Czasopismo
Rocznik
Tom
74
Numer
3
Opis fizyczny
p.389-395,fig.,ref.
Twórcy
  • Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
autor
  • Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
autor
  • Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
autor
  • Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
autor
  • Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
Bibliografia
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  • 3. Bhathena HM, Kavarna NM (1993) One stage reconstruction of extensive abdominal wall defect with bilateral tensor fascia lata flap. Indian J Cancer, 30: 10–15.
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  • 5. Contedini F, Negosanti L, Pinto V, Tavaniello B, Fabbri E, Sgarzani R, Tassone D, Cipriani R (2013) Tensor fascia latae perforator flap: an alternative reconstructive choice for anterolateral thigh flap when no sizable skin perforator is available. Indian J Plast Surg, 46: 55–58.
  • 6. Demirseren E, Gokrem S, Ozdemir OM, Can Z, Serel S (2003) Hatchet shaped tensor fascia lata musculocutaneous flap for the coverage of trochanteric pressure sores: a new modification. Ann Plast Surg, 51: 419–422.
  • 7. Endo T, Nakayama Y, Soeda S (1991) Reconstruction of the cheek and palate using a three-paddle tensor fasciae latae free flap. Br J Plast Surg, 44: 234–235.
  • 8. Ercocen AR, Apaydin I, Emiroglu M, Yilmaz S, Adanali G, Tekdemir I, Yormuk E (1998) Island V-Y tensor fasciae latae fasciocutaneous flap for coverage of trochanteris pressure sores. Plast Reconst Surg, 102: 1524–1531.
  • 9. Fukuda H, Ashida M, Ishii R, Abe S, Ibukuro K (2005) Anatomical variants of the lateral circumflex artery: an angiographic study. Surg Radiol Anat, 27: 260–264.
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  • 14. Hubmer MG, Schwaiger N, Windisch G, Feigl G, Koch H, Haas FM, Justich I, Scharnagl E (2009) The vascular anatomy of the tensor fasciae latae perforator flap. Plast Reconstr Surg, 124: 181–189.
  • 15. Ishida LH, Munhoz AM, Montag E, Alves HR, Saito FL (2005) Tensor fasciae latae perforator flap: minimizing donor-site morbidity in the treatment of trochanteric pressure sores. Plast Reconstr Surg, 116: 1346–1352.
  • 16. Jovanovic M, Colic M. Stefanovic P, Ronevic R, Rasulic L, Karapandic M (2004) Anatomic analysis of the vascular network and vascular pedicle of the tensor fascia lata flap (angiographic and cadaver study). Eur J Plast Surg, 27: 61–67.
  • 17. Kawai K, Imanishi N, Nakajima H, Aiso S, Kakibuchi M, Hosokawa K (2004) Vascular anatomy of the anterolateral thigh flap. Plast Reconstr Surg, 114: 1108–1117.
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  • 23. Mathes JS, Nahai F (1982) Clinical applications for muscle and musculocutaneous flaps. Mosby, St. Louis, pp. 99–151.
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  • 32. Stefanovic P, Jovanovic M, Antoniou A (2000) Review of the vascular territory of tensor fasciae latae flap. [Article in Serbian] Medicinska Istrazivanja, 34: 5–11.
  • 33. Tukiainen E, Leppaniemi A (2011) Reconstruction of extensive abdominal wall defects with microvascular tensor fasciae latae flap. Br J Surg, 98: 880–884.
  • 34. Uzel M, Tanyeli E, Yildrim M (2008) Anatomical study of the origin of LCFA in Turkish population. Folia Morphol, 67: 226–230.
  • 35. Valdatta L, Tuinder S, Buoro M, Thione A (2002) Lateral circumflex femoral arterial system and perforators of the anterolateral thigh flap: an anatomic study. Ann Plastic Surg, 49: 145–150.
  • 36. Vegas MR, Martin-Hervas C (2013) The superolateral thigh flap: cadaver and computed tomographic angiography studies with a clinical series. Plast Reconstr Surg, 131: 310–322.
  • 37. Vuksanovic A, Ugrenovic S, Jovanovic I (2006) Vascular stalk analysis of the tensor fasciae latae flap. Facta Universitatis, Series Medicine and Biology, 13: 1–5.
  • 38. Wangesteen OH (1934) Repair of recurrent and difficult hernias and other larger defects of the abdominal wall employing the iliotibial tract of fascia lata as pedicled flap. Surg Gynecol Obstet, 59: 766–780.
  • 39. Yousif NJ, Ye Z (1991) Analysis of cutaneous perfusion: an aid to lower extremity reconstruction. Clin Plast Surg, 18: 559–570.
Typ dokumentu
Bibliografia
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Identyfikator YADDA
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