The radial artery pedicle perforator flap: Vascular analysis and clinical implications

Michel Saint-Cyr, Mirsad Mujadzic, Corrine Wong, Dan Hatef, Andrew S. Lajoie, Rod J. Rohrich

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

Background: The purpose of this study was to determine the location, size, and vascular territory of the radial artery cutaneous perforators. Methods: Twenty-six human cadaveric forearms were dissected. All cutaneous radial artery perforators were analyzed for total number, orientation, location, and external diameter. A cluster analysis was performed to determine the overall distribution of perforators. The cutaneous territory of a distally based pedicled perforator flap was determined using methylene blue injection and three-dimensional computed tomographic angiography in five flaps. Results: Six hundred thirty-nine perforators (399 perforators smaller than 0.5 mm compared with 240 perforators 0.5 mm or larger) were dissected in 26 forearms. Of the 639 radial artery perforators dissected, 328 (51 percent) were radially distributed and 311 (49 percent) were ulnarly distributed. There are two main clusters of clinically relevant perforators at a relative distance of 17.6 percent and 61.7 percent along the radial styloid-to-lateral epicondyle interval. In all cases, two or more perforators were found within 2 cm proximal to the styloid. Dye injection of the most dominant distally based perforators revealed a cutaneous territory ranging from 104 cm2 to 333 cm2. The case presented is of a patient with a dorsal hand defect, which was resurfaced with a pedicled perforator flap based on a distal perforator proximal to the radial styloid. Conclusions: There are two main clusters of clinically significant radial artery perforators. Increased knowledge of size, location, and cutaneous territory of the radial artery perforators can lead to expanded use of the radial artery forearm flap based on cutaneous perforators alone, without sacrificing the radial artery.

Original languageEnglish (US)
Pages (from-to)1469-1478
Number of pages10
JournalPlastic and reconstructive surgery
Volume125
Issue number5
DOIs
StatePublished - May 1 2010

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'The radial artery pedicle perforator flap: Vascular analysis and clinical implications'. Together they form a unique fingerprint.

Cite this