title: Anatomy of the proximal cutaneous perforator vessels of the gracilis muscle.
abstract: An anatomic study was performed to analyse the proximal perforator vessels of the gracilis musculocutaneous flap. Twenty-three cadaver legs preserved by the method of Thiel were carefully dissected 24h after the proximal vascular pedicle was injected with a red silicone mass. Nine additional cadaver legs were injected with ink, to visualise the skin area supplied by the proximal perforators, respectively, clarified by a modified Spalteholz technique to demonstrate the anatomic course of the perforators. A considerable variation in numbers and localisation of proximal cutaneous perforators was found. One to four perforators were seen within an area of 6 x 6 cm(2) at the entrance of the main pedicle into the proximal gracilis muscle. Their external diameter ranged from 0.5 to 1.0 mm. The ink-injections showed an oval shaped angiosome with a mean surface of 88 cm(2) at the level of the proximal gracilis pedicle. We conclude from this anatomic study, that a cutaneous flap based on the medial circumflex femoral gracilis perforators can be harvested by experienced hands bearing in mind the unpredictable perforator-anatomy.
authors.affiliation: Department of Orthopaedic, Plastic and Reconstructive and Hand Surgery, Inselspital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
authors.forename: U A
authors.initials: UA
authors.lastname: Kappler
authors.forename: M A
authors.initials: MA
authors.lastname: Constantinescu
authors.forename: U
authors.initials: U
authors.lastname: Büchler
authors.forename: E
authors.initials: E
authors.lastname: Vögelin
mesh_terms: D001158:Arteries / Q000033:anatomy & histology; D005263:Femoral Artery / Q000033:anatomy & histology; D006801:Humans; D007203:Indigo Carmine; D018482:Muscle, Skeletal / Q000098:blood supply*; D012828:Silicones; D012867:Skin / Q000098:blood supply*; D013524:Surgical Flaps / Q000098:blood supply*; D013848:Thigh / Q000098:blood supply*
chemical_list: D012828:Silicones; D007203:Indigo Carmine