Measurement Of The Thickness Of Subcutaneous Fat And Clinical Applied Anatomy Of Cutaneous Perforators Vessels In Anterior Thigh Region

ObjectiveTo measure the thickness of subcutaneous fat in different parts of anterior thigh region and explore the distribution, number, types and sources of cutaneous perforators of anterior thigh region. Provide clinical guidance on making single-island flap and multi-islands flap in anterior thigh region.Methods66 cases from October 2008 to April 2009 in the second XiangYa Hospital, Central South University were selected. They all have suffered the resection of oral and maxillofacial malignant and in I phase reconstruction with free flaps of left anterior thigh region. The anterior thigh region was divided into anterolateral thigh region and anteromedial thigh region, which was further divided into upper, middle and lower regions. 1. Measure the thickness of subcutaneous fat in different parts of anterior thigh region. 2.with the incision of flaps ,to explore the perforator's distribution, number, types and sources in left anterior thigh region. In the exploration, as far as possible not to increase the local injury.Results1 . In anterior thigh region, the thickness of subcutaneous fat of the lower part the lower part > the upper part. The average cutaneous perforators of anterolateral thigh region is 4.4±1.4, the lower part have more cutaneous perforators(1.9±0.8) than the upper(1.4±0.5) and middle (1.6±0.6) parts. Among the cutaneous perforators, 76.3% arises from descending branch, 19.2% arises from transverse branch, 1.4% arises from ascending branch, 3.1% arises from other vessels. 3. All of the lower, middle and upper parts of anteromedial thigh region have cutaneous perforators, the upper part have 17.1%, the middle part have 35.7%, the lower part have 46.3%.The probability of cutaneous perforators in lower part, middle part and upper part is 95.5%, 84.9% and 51.5%,the lower part >the middle part > the upper part. The average cutaneous perforators of anteromedial thigh region is 3.3±1.1. The cutaneous perforators are mainly arise from the femoral artery and its branches, most of them are musculocutaneous perforators. 57.6 percent of the cases (38/66) has cutaneous perforators which arise from descending branch of the lateral circumflex femoral artery in the anteromedial thigh region.Conclusions1. Between the upper and lower parts of anterior thigh region, the difference of thickness of subcutaneous fat is obvious, the lower part