Applied Anatomy Of Retrograde Sartorius Myocutaneous Flap For Repairing Skin Defect On Legs

Objective: To provide the anatomical basis for repairing skin defects on legs by retrograde sartorius myocutaneous flap. Methods: The origin, courses, diameter, distribution and anastomosis of sartorius's vascular were explored in 40 cadaveric lower limb specimens. Arteriographies were made in 4 sides of fresh specimens to study the artery anastomosis in sartorius. Results: Sartorius's nutrient artery assumed segmental distribution, included 6-7 vascular pedicles. The vascular pedicles in proximal 1∕5 segment of sartorius came from superficial ilium circumflex artery, lateral femoral circumflex artery or deep femoral artery,from femoral artery in middle 2/5 segment,and from saphenous artery in distal 2/5 segment. The diameter of saphenous artery's origin point is (1.5±0.2)mm ,(10.2±1.0)cm proximal to adductor tubercle level.The artery came into sartorius as 3-5 branchs. The terminal branches of saphenous artery pass inside and below the knee joint, composing an arterial network around knee joint. Artery pedicles entered into sartorius and passed along it's vertical axis as 4-7 branches in each segment.Interlocking arterial anastomosises were formed by branches of adjacent vascular pedicles . The diameter is about 0.3mm at anastomosise point. Cutaneous arteries and musculocutaneous arteries above deep fascia formed interlocking arterial anastomosis net which provided blood supply for the skin on sartorius.Conclusion: Interlocking arterial anastomosises in sartorius provided blood supply for reverse-flow sartorius myocutaneous flap,and enlarged cutting length of the myocutaneous flap.Above all , retrograde sartorius myocutaneous flap with saphenous artery pedicle can be used to repair soft tissue defect on middle and distal section of the legs.