title: Breast reconstruction using free posterior medial thigh perforator flaps: intraoperative anatomical study and clinical results.
abstract: BACKGROUND
  The free posterior medial thigh perforator flap is a fasciocutaneous flap on the posterior and medial thigh, based on perforators from the deep femoral vessels. In this study, the authors evaluated the anatomical basis of posterior and medial thigh perforators from the deep femoral vessels.
  
  
  METHODS
  Between June of 2006 and May of 2012, 67 patients underwent breast reconstruction using the posterior medial thigh flap. Perforators greater than or equal to 0.5 mm in this region were investigated. The following parameters were recorded intraoperatively: number of perforators, perforator diameters, perforator locations, pedicle length, and distance of the perforating point from the proximal thigh crease.
  
  
  RESULTS
  Of 70 flaps, 69 survived, but one developed total necrosis. The total number of perforators was 272, and the mean number was 3.9. The number of perforators coursing through the adductor magnus muscle was largest, followed by those coursing between the adductor magnus and semimembranosus muscle septocutaneously. Musculocutaneous perforators from the adductor magnus were located more proximally than the septocutaneous perforators between the adductor and semimembranosus muscle.
  
  
  CONCLUSIONS
  The posterior medial thigh flap is suitable as a first-line option for breast reconstruction in women with a small to moderate breast size. This flap provides enough large perforators to support a soft-tissue transfer from the posterior and medial thigh.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Yokohama, Kanagawa, Japan From the Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Satake
authors.forename: Mayu
authors.initials: M
authors.lastname: Muto
authors.forename: Seiko
authors.initials: S
authors.lastname: Ko
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yasumura
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Jiro
authors.initials: J
authors.lastname: Maegawa
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D007564:Japan; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D013848:Thigh / Q000033:anatomy & histology* / Q000098:blood supply / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult