Chapter 2 Figure 2.2 (A) A dissected perforator in the subcutaneous plane. (B) A musculocutaneous perforator running from the rectus femoris muscle toward the anterolateral thigh flap. The red Biodur resin makes the presence of the perforator more visible. (C) The design of an anterolateral thigh flap based on two musculocutaneous perforators crossing the rectus femoris muscle. One to four perforators were located in each thigh. At least one perforating vessel was found in each of the studied thighs. On average, 2.1 perforators per thigh were identified. The external diameter of the perforators was extremely variable (0.85 mm on average). Twelve perforators were located between the superior and middle third of the line drawn from the anterior superior iliac spine to the lateral border of the patella. Nineteen perforators were found in the middle third, and the other three were located in the inferior third of that line. All the perforators nourishing the antero- lateral thigh flap were identified by us and dissected up to their origin, were derived from the descending branch of the lateral circumflex femoral artery. Cadavers 5, 7, 9, 10, and 11 presented a division of the descending branch into a lateral descending branch and a medial descending branch. The perforators arose from the lateral descending branch (Fig 2.3). 23
5. lay-out phd DEFINITIEF_digitaal2
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