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KMID : 0358819820090010011
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Journal of Korean Society of Plastic and Reconstructive Surgeons
1982 Volume.9 No. 1 p.11 ~ p.18
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STUDY ON VASCULAR ANATOMY FOR INGUINAL FLAP FORMATION
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고병천/Ko, B.C.
이영호/유재덕/Lee, Y.H./Lew, J.D.
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Abstract
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In the field of plastic surgery, the flap has been a part of the reconstruction procedure and is a continuously developing one. Among generally practiced free flaps, the inguinal free flap is known to satisfy most of the prerequisites which a free flap must come to meet the condition(Morrison & O´ Brien, 1980). Since Daniel and Taylor ( 1973) have succeeded inguinal free flap, numerous successful results were reported.
However, since neither general anatomy textbooks mention about the distribution of the inguinal blood vessels in detail, nor any domestic reports are satisfactory for clinical use, we observed and analyzed exclusively the origin of the superficial cricumflex iliac artery (S CIA), superficial interior epigastric artery (SIEA) , their diameters at the origin, the relationship between the origin of the artery and inguinal ligament and the relationship between the two arteries, the relationship between the inguinal vessel and basic marks, the distribution and the size of the superificial circumflex iliac vein (SCIV) and superficial interior epigastric vein (SIEV) and location of the saphenous bulb by the dissections of 20 adult cadavers (18: bilateral, 2 : unilateral )
The results were summerized as follows
1. SCIA and SIEA arise from the femoral artery in 7 cases (18.4%) as common trunk : In 5 cases (13.2%) as compensatory SCIA : in 26 cases (68.4%) as seperate origins. Origins other than femoral artery are from deep femoral artery, superficial pudendal artery and deep pudendal artery as total of 11 cases (28.9%) Symmetrical bilaterality of the arterial origin was about 40 %.
2. The diameters at their origins of the SCIA and the SIEA are ; common trunk, 1.6 (1.3 - 2.0-) ; compensatory SCIA, 1.3- (1.2 - 1.5 ) : seperale origins, SCIA and SIEA respectively 1.2- (0.6 - 2.0 -) and 1.3 z (0.8 - 2.0 m)
3. All arteries at their origins are located within 5cm below the inguinal ligament , except for 7 cases which have seperate origins, 4 of SIEA , and 3 of SCIA are located beyond 5cm mark. 4. In cases of seperate origin, the SCIA arises superior to SIEA in 20 cases (76.9%) and vice versa in 4 cases (15.4%), Only 2 cases (7.7%) arises at same level
5. The SCIV and SIEV drain into a common trunk in 15 cases (39.5%), and
into seperate veins in 23 cases (60..50%). The diameter of the veins of the common trunk is 2.3x** (2.0-5.0m), In cases of separate drainage, the SCI V and SIEV are 1.9 an (1.2 - 2.0 an and 2.1 an (1.2 - 2.5 an) respectively and the saphenous bulb is located 4.4 cm in an averge below the inguinal ligament
6. In our cases, the SCIA & SCIV run laterally below & parallel to the inguinal ligament beneath the deep fascia giving off several cutaneous branches until the when the vessels travel into the subdermal plexus extending laterally in a distance of average 5 cm
The SIEA & SIEV pierce the deep fascia below the inguinal ligament & travel cranially crossing the´ ligament continuously just superficial to the deep fascia in the lower abdomen giving off numerous branches which makes the abundant networks c others
Identification of these vascular territory is easily disclosed within a distant of at least 10cm cranial (above) to the inguinal ligament.
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KEYWORD
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