Neurovascular Anatomy

The deep inferior epigastric vascular pedicle arises from the external iliac inferior and deep to the inguinal ligament and courses superomedially to enter the lateral aspect

Table 1 Characteristics of Free Flaps

SimHarvest PedLength VDiam ADiam EHarvest DSMorb Sensory Motor

Table 1 Characteristics of Free Flaps

SimHarvest PedLength VDiam ADiam EHarvest DSMorb Sensory Motor

Rectus abdominis

Z

Z

Z

Z

Z

Z

Z

Pectoralis minor

Z

Z

Z

Gracilis

Z

Z

Z

Z

Z

Fibular osteocutaneous

Z

Z

Z

Z

Z

Radial forearm

Z

Z

Z

Z

Z

Scapular system of flaps

Z

Z

Z

Z

Dorsalis pedis

Z

Z

Z

Iliac osteocutaneous

Z

Z

Z

Lateral arm

Z

Z

Z

Z

Z

Z

Lateral thigh

Z

Z

Z

Z

Z

Omental/gastro-omental

Z

Z

Z

Z

Z

Jejunal

Z

Z

Z

Z

SimHarvest: The flap can be harvested simultaneously while the head and neck donor site is being prepared or extirpated thereby significantly reducing operative time.

PedLength: Pedicle lengths of over 6 cm are favorable to reach most donor vessels in the head and neck.

VDiam/ADiam: Arterial and venous diameters over 1.5 mm make microvascular anastomoses less technically demanding.

EHarvest: The overall ease of harvest describes whether the patient must be repositioned to harvest the flap or if the dissection is tedious and time-consuming.

DSMorb: Trouble-free donor site with regard to aesthetics and function / low risk of postoperative morbidity.

Sensory: The ability to re-establish sensation via neurorrhaphy.

Motor: A motor nerve is associated with the flap for reinnervation.

SimHarvest: The flap can be harvested simultaneously while the head and neck donor site is being prepared or extirpated thereby significantly reducing operative time.

PedLength: Pedicle lengths of over 6 cm are favorable to reach most donor vessels in the head and neck.

VDiam/ADiam: Arterial and venous diameters over 1.5 mm make microvascular anastomoses less technically demanding.

EHarvest: The overall ease of harvest describes whether the patient must be repositioned to harvest the flap or if the dissection is tedious and time-consuming.

DSMorb: Trouble-free donor site with regard to aesthetics and function / low risk of postoperative morbidity.

Sensory: The ability to re-establish sensation via neurorrhaphy.

Motor: A motor nerve is associated with the flap for reinnervation.

of the rectus muscle near the arcuate line (Fig. 30). Within the vascular pedicle lie the inferior epigastric artery and the venae comitantes. The musculocutaneous perforators from the deep inferior epigastric artery tend to follow two vertical parallel lines that course along the midpoint and lateral border of the muscle. They are most numerous at the umbilicus (paraumbilical perforators). A single paraumbilical perforator can supply virtually any size of paramedian or transverse skin paddle (Fig. 31). The smaller superior epigastric vascular pedicle (the continuation of the internal mammary artery) enters the rectus muscle superomedially. Although the flap can be sustained by this pedicle, it is rarely used for microvascular anastomosis because of deficiencies in pedicle size and length. The motor nerve supply is segmental originating from the T7 through T12 intercostal nerves along the muscle's lateral border.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

Get My Free Ebook


Post a comment