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KMID : 0603120130220020043
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Journal of the Korean Microsurgical Society
2013 Volume.22 No. 2 p.43 ~ p.47
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Application of Lumbar Artery Perforator Flap for Reconstruction of Back Ulcer: Clinical Study with Computed Tomographic Angiography
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Cho Jin-Woo
Kim Deok-Woo
Kim Deok-Yeol
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Abstract
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Purpose: Un-healing and centrally located defect on back area, it is sometimes a challengefor the reconstructive surgeon. Although skin grafts are considered as the first choicefor reconstruction of large skin defect on the back region, it is not always helpful butvascularized flaps provide a superior functional and aesthetic outcome. The present studywas designed to investigate the clinical anatomy of the lumbar artery perforator flap toreconstruct back ulcer.
Materials and Methods: Clinical anatomy study was undertaken using computedtomographic angiographic analysis. We identified the courses of lumbar arteries and itsperforators, measured pedicle length by layers. The location of the perforator vessel wascharted against anatomical landmarks.
Results: The pedicle lengths of the third and fourth lumbar artery perforator reached amean of 27.8 mm and 37.1 mm respectively from superficial fascia to deep fascia. Thefourth perforator was more laterally located than the third perforator and less than 1 cmabove the iliac crest. A case in which the fourth lumbar artery perforator was used as flappedicle is described.
Conclusion: For the reconstruction of central defect on the back area, the lumbar arteryperforator flap coverage may be a good alternative option. Computed tomographicangiography can easily identify the course and location of lumbar artery perforators andcan be helpful to elevate the flap successfully.
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KEYWORD
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Lumbosacral resion, Wound closure technique, Perforator flap
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