Anatomical Study Of The Crossing Area Supply Axial Pattern Flap In Cervico-acromion And Clinical Application

Objective To investigate the blood supply of the crossing area supply axial pattern flap in cervico-acromion and its application on the reparation of cervical and thracic defect due to scar resection.Method Microsurgical anatomical study was carried out on10fresh and15processed cervico-acromions of human cadavers,which had been injected with red and blue latex.The study was focused on the origin,numbers,position and vascular anastomosis of perforator artery(diameter≥0.30mm)in the cervico-acromions district.The flaps were used on15cases to repair the cervical and thoracic defect.Result1、These cutaneous arteries given off from brachial artery and the ramus anastomoticus at the layer of the deep fascia tend to anatomose in the deep fascial, superficial fascia and subdermal level respectively.They shape the vascular network on the deep fascia,in the superficial fascia level are the main supplying vessels.More ramus anastomoticus are observed on the frontal of trapezius.Most of the cutaneous artery perfortors in30cervico-acromions locate at the the frontal of trapezius2、The crossing area supply axial pattern expanded skin flaps from cervico-acromion were used on15cases to repair the cervical and thoracic defect.The maximum area of the flap was23cm*16cm,and the minimum was22cm*10cm。The flap was separated on the deep fascia.All flaps survived.The donor sites were sutured directly except one case in which the donor site were covered with free graft.The results were satisfying.Conclusion The blood supply of the crossing area supply axial pattern flap pedicled with superficial branch of transverse cervical artery in cervico-acromion is sufficient. Reparation of cervical and thoracic defects with the flaps after expanding could be recommended because of its nearly skin color,texture and contour.Larger flap can be obtain after expending.