Microvascular Study And Clinical Using Of Transmidline Scapular Flap Vascularied By Contralateral Circumflex Scapular Artery

Reconstructive procedures in the head and neck region use a wide range of flaps for defect closure. The methods range from local flaps and skin grafts to free microsurgical flaps. To ensure a satisfactory functional and aesthetic result, good texture and color of the flap are always essential. Moreover, the donor-site defect needs to be reduced, with no resulting functional or aesthetic impairment. We have found that the back is a region providing an optimum skin texture match to the neck and face and the scapular flap is a good choice.In order to expand the use of the scapular flap,We study the microvascular architecture of transmidline scapular flap vascularied by contralateral circumflex scapular artery ,meanwhile we use the flap in clinic and gain success.In the 6 fresh cadavers,we injected with vermilion mixture in the unilateral circumflex scapular artery ;the integument and deep tissues were dissected and radiographed. We finds if we perfuse the circumflex scapular artery with normal systolic pressure,almost the whole back can be found the vermilion but the density is different. The vasular tree can not only pass the midline but also can get the contralateral acromion The irrigating side of the back show a highest intensive vessels ;in the midline area ,we also can see a higher vessel density but in the distal part of contralateral back,the high density of the vessel mainly concentrate in the upper part of the back.In the medial part of the acromin and in upside of the scapular inferior angle,there are a relatively high density vessel.In the other part of the contralateral back,the vessels are relatively rare. Transmidline part of the vasular tree mainly focus in the upper part of the back.The results tell us that if we lift a transmidline scapular flap vascularied by contralateral circumflex scapular artery,we should cut off the flap in the oppsite part of the back mainly in the upper part.We also injected with Latex and ink mixture in the unilateral circumflex scapular artery and lift the transmidline flap.The flap were made to be Pellucidum specimen.Our results are almost the same to the radiograph's. The sites of the artery perforators were plotted and traced to their underlying parent vessels that accompany the source (segmental) arteries. A series of cross-sectional studies were made in one subject to illustrate the course of the perforators between the integument and the deep tissues. In the deep fascia,superfacial fascia,subdermis layer and dermis layer. Microvascular connection is rich. There are three patterns: aortic...