title: Evaluating anatomical research in surgery: a prospective comparison of cadaveric and living anatomical studies of the abdominal wall.
abstract: BACKGROUND
  Cadaveric research has widely influenced our understanding of clinical anatomy. However, while many soft-tissue structures remain quiescent after death, other tissues, such as viscera, undergo structural and functional changes that may influence their use in predicting living anatomy. In particular, our understanding of vascular anatomy has been based upon cadaveric studies, in which vascular tone and flow do not match the living situation.
  
  
  METHODS
  An angiographic analysis of the abdominal wall vasculature was performed using plain film and computed tomography angiography in 60 cadaveric hemi-abdominal walls (from 31 cadavers) and 140 living hemi-abdominal walls (in 70 patients). The deep inferior epigastric artery (DIEA) and all of its perforating branches larger than 0.5 mm were analysed for number, calibre and location.
  
  
  RESULTS
  Both large, named vessels and small calibre vessels show marked differences between living anatomy and cadaveric specimens. The DIEA was of larger diameter (4.2 mm versus 3.1 mm, P < 0.01) and had more detectable branches in the cadaveric specimens. Perforators were of greater calibre (diameter 1.5 mm versus 0.8 mm, P < 0.01) and were more plentiful (16 versus 6, P < 0.01) in cadaveric specimens. However, the location of individual vessels was similar.
  
  
  CONCLUSIONS
  Cadaveric anatomy displays marked differences to in vivo anatomy, with the absence of living vascular dynamics affecting vessel diameters in cadaveric specimens. Blood vessels are of greater measurable calibre in cadaveric specimens than in the living. Consequently, cadaveric anatomy should be interpreted with consideration of post-mortem changes, while living anatomical studies, particularly with the use of imaging technologies, should be embraced in anatomical research.
authors.affiliation: Reconstructive Plastic Surgery Research Unit, Room E533, Department of Anatomy and Cell Biology, The University of Melbourne, Grattan St, Parkville, Vic. 3050, Australia. warrenrozen@hotmail.com
authors.forename: Warren M
authors.initials: WM
authors.lastname: Rozen
authors.forename: Daniel
authors.initials: D
authors.lastname: Chubb
authors.forename: Damien L
authors.initials: DL
authors.lastname: Stella
authors.forename: G Ian
authors.initials: GI
authors.lastname: Taylor
authors.forename: Mark W
authors.initials: MW
authors.lastname: Ashton
mesh_terms: D034861:Abdominal Wall / Q000098:blood supply*; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D035843:Biomedical Research; D002102:Cadaver; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D013514:Surgical Procedures, Operative