title: Redefining the vascular anatomy and clinical applications of the sartorius muscle and myocutaneous flap.
abstract: BACKGROUND
  The sartorius muscle is a superficial thigh muscle with specific anatomical characteristics in terms of shape and vascular supply. Few studies have assessed the vascular supply of the muscle and overlying skin paddle and its potential in reconstructive surgery. The study used three-dimensional, four-dimensional imaging to analyze the segmental vascularity of the muscle, as well as the overlying skin paddle, to define arcs of rotation based on its major pedicles.
  
  
  METHODS
  Thirty sartorius muscles and the circumferential skin of the thigh were harvested from adult cadavers. Anatomic considerations, such as pedicle number, location, diameter, and length, were recorded. Three-dimensional and four-dimensional computed tomography angiography was used to measure the length of muscle perfused by a single pedicle defined as a major pedicle. Lastly, the area of cutaneous territory supplied by each major pedicle was calculated.
  
  
  RESULTS
  The sartorius muscle is supplied by six to eight vascular pedicles. Two clusters of major pedicles (diameter greater than 1.8 mm) were described (proximal and distal), which are located 18 to 25 cm and 35 to 44 cm from the anterior superior iliac spine, respectively. The proximal major pedicle perfuses almost 80 percent of the muscle, and the distal major pedicle perfuses almost 90 percent. The average area of skin perfused was 330 cm.
  
  
  CONCLUSIONS
  This study suggests greater anatomical assurance of the potential use of the sartorius muscle and its overlying skin as a local transposition and free flap. The vascular supply of the muscle and skin by two major pedicles allows two pivot points for muscular or musculocutaneous flaps. The various applications for reconstructive surgery based on these arcs of rotation are discussed.
authors.affiliation: Lyon, France; and Dallas, Texas From the Department of Plastic Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, University of Lyon, and Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Ali
authors.initials: A
authors.lastname: Mojallal
authors.forename: Corrine
authors.initials: C
authors.lastname: Wong
authors.forename: Christo
authors.initials: C
authors.lastname: Shipkov
authors.forename: Christophe
authors.initials: C
authors.lastname: Hocuoq
authors.forename: Javier
authors.initials: J
authors.lastname: Recchiuto
authors.forename: Spencer
authors.initials: S
authors.lastname: Brown
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
authors.forename: Michel
authors.initials: M
authors.lastname: Saint-Cyr
mesh_terms: D000328:Adult; D002102:Cadaver; D006801:Humans; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000637:transplantation; D012867:Skin / Q000098:blood supply*; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply*; D013848:Thigh / Q000033:anatomy & histology* / Q000601:surgery