title: Skin perforators of back region: anatomical study and clinical applications.
abstract: BACKGROUND
  Despite widespread studies that have been commonly performed recently on skin perforators and perforator flaps of various regions of the body, investigations on the back region of the body are still insufficient. This study investigates the anatomical characteristics and clinical applications of perforating vessels in the back region.
  
  
  METHODS
  The skin on the back region between the right and left, 7th to 11th thoracic vertebrae of 10 fresh cadavers were raised as flaps. Perforating vessels perfusing the skin with pedicle diameters of over 1 mm were included in the study. The anatomical localization, diameter, pedicle size, and the supplying vessels of these pedicles were determined. Utilizing this information, the defects of 8 patients with large meningomyeloceles included in the study were closed with prepared intercostal artery perforating flap.
  
  
  RESULTS
  Perforators of the back region were seen to originate from the posterior intercostal vessels. There were a higher number of perforators on the right side of the body. The most commonly observed perforators were the 7th and 9th posterior intercostal perforators, and their diameters were larger. All flaps were viable following perforator flap closure for defects in 8 patients with large meningomyelocele included in the clinical study. No problems were encountered in the postoperative 3-month follow-up of cases.
  
  
  CONCLUSIONS
  Owing to the low donor area morbidity and wide motion capabilities, the perforator flap is a new choice of flap for the back region. Perforator pedicle flaps supplied by the posterior intercostal vessels may be safely used in congenital tissue defects, such as meningomyelocele, tumors, and traumatic defects.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Medical Faculty, Yuzuncu Yil University, Van, Turkey. drbekiratik@yahoo.com
authors.forename: Bekir
authors.initials: B
authors.lastname: Atik
authors.forename: Onder
authors.initials: O
authors.lastname: Tan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Mutaf
authors.forename: Berna
authors.initials: B
authors.lastname: Senel
authors.forename: Nebi
authors.initials: N
authors.lastname: Yilmaz
authors.forename: Nejmi
authors.initials: N
authors.lastname: Kiymaz
mesh_terms: D000328:Adult; D001415:Back / Q000098:blood supply / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008591:Meningomyelocele / Q000601:surgery*; D008875:Middle Aged; D012867:Skin / Q000098:blood supply; D013524:Surgical Flaps / Q000098:blood supply*