The Anatomy Study Of Cutaneous Artery Flap Of The Radial Forearm

Objective:Through microsurgical anatomy of the 10 fresh specimens of adult upper limb, understanding the source,the starting point,the outer diameter and the accompanying vein of the cutaneous of forearm skin,to provide anatomical basis for the design and clinical applications of cutaneous artery flap on the radial forearm.Methods:Select 10 upper side of fresh adult specimens,5 right and 5 lift,to perfusion the specimens with the staining emuision,archive the specimens in the plastic bags,and then put in the refrigerator.When use it,take the specimens to the room temperature for 24 hours before the experiment.Cut the skin on the midline of the forearm,to the deep fascia find the cutaneous,along the muscle clearance between the brachioradialis muscle and flexor carpi radialis to find the radial artery.To microsurgical anatomy of the specimens and observed the perforating branches issued by the brachial artery,radial artery and so on.The observations the cutaneous included:the location,the outer diameter,the length,the breaches of the perforating branches,also to observe the connected of the cutaneous arteries and the blood supply area.To design the cutaneous arteries flap on the radial forearm.Result:In the 10 case of sample,the cutaneous arteries of the radial forearm about 8 to 12, which direct cutaneous artery 2～3, muscular artery in space 3～5, musculocutaneous artery in 3～4. The outer diameter of the cutaneous artery from forearm which in proximal 1/3 and middle 1/3 is 0.53±0.09mm and in distal 1/3 have a smaller outer diameter. In distal 1/3 has a cutaneous, the distance from the radial styloid process at about 4.2±0.6cm, diameter of about 0.62±0.08mm.The perforating branches pierced the deep fascia on the radial forearm and line a chain that arranged in longitudinal,when the perforating branches into the superficial fascia they will connect each other,become a arterial net.The count of the perforating branches origin from the brachial artery are1～3.The starting point of diameter is 1.06±0.13mm,the diameter of the cutaneous is 0.51±0.06mm. When the piercing point in the forearm the distance between the perforating branches and epicondyle of the humerus is 1.8±0.9cm, when the piercing point in the arm the distance.between the perforating branches and epicondyle of the humerus is 1.0±0.4cm.In the case,the count of the perforating branches origin from the radial artery are6-9.The starting point of diameter is 1.07±0.11mm,the diameter of the cutaneous is 0.53±0.04mm. The distance between the starting point of the perforating branches and epicondyle of the humerus are3.5±1.4cm, the distance between the perforating branches pierce into the deep fascia and epicondyle of the humerus is 7.9±2.8cm.Among 10 side of the specimens,the radial recurrent artery all origin from radial artery,the count of the cutaneous origin from the radial recurrent artery are 1～3.The starting point of diameter is 1.10±0.11mm,the diameter of the cutaneous is 0.55±0.04mm.The starting point can be the proximai humeral epicondyle 1.5±0.4cm, also can be the humeral epicondyle distal 2.7±1.0cm.We found that the chain of the cutaneous performed longitudinal rows when they pierced the deep fascia. The cutaneous pierced out the deep fascia have the secondary branches. They scattered around in the superficial fascia,the secondary branches connected with each other that become a net,through the microscopic anatomical methods we knew the blood supply range. ConclusionThrough microsurgical anatomy of the 10 fresh specimens of adult upper limb. Determine the blood supply artery, manner and scope of the blood supply in the radial forearm skin,to provide the anatomical basis for designing and clinical application of the flap.There are several cutaneous in the radial forearm,we can use one of them as a vascular pedicle of the flap to design the cutaneous artery flap on radial forearm.The design of the cutaneous artery flap on radial forearm provided a constant vascular pedicle, good texture, the operation is simple, safe and reliable flap to repair soft tissue defects on forearm and wrist area.