Analyzing the the distribution characteristics of anterolateral thigh flap perforators by coordinate positioning method
Objective:To describe and analyze the distributive characteristics of perforators of anterolateral thigh flap(ALTF)by coordinate positioning method,and to provide a reference for the anatomy and selection of the perforators of ALTF in clinic.Methods:A total of 83 cases conducted with ALTF repair in our hospital from May 2021 to July 2024 were selected for the study.The ALTFs were harvested and the surgical data were recorded,the surgical data included the location and num-ber of perforators,the origin and types of walking path of the main perforators,the diameters of perforators and vascular pedi-cle vessels,the thickness and the length of the pedicle,the operation time,the incidence of flap crisis and the outcome of flap repair.The position of perforators were recorded by coordinate positioning method,the distribution characteristics was ana-lyzed,and the relationship between the distribution of perforators and the anatomic characteristics was analyzed.Results:The main perforators of the ALTFs showed a dumbbell-like symmetrical distribution in the proximal cardiac region to distal cardiac region direction.There were more perforators came from oblique and transverse branches in the proximal region,and more perforators came from descending branches in the distal cardiac region(P<0.05).The proximal perforators were mainly com-posed of septocutaneous perforator and musculoseptocutaneous perforators,while the distal perforors were mainly composed of musculoseptocutaneous perforators and musculocutaneous perforators(P<0.05).The diameters of usable perforators in the proximal cardiac region were larger than those in the distal region(P<0.05),while the diameters of main perforators,pedicle arteries and pedicle veins between the proximal and distal cardiac regions had no statistical difference(P>0.05).The thick-ness of flaps in the proximal cardiac region was greater than that in the distal cardiac region while the length of the vessel pedicle in the distal cardiac region was longer than that in the proximal cardiac region(P<0.05).The harvesting time of ALTF the proximal cardiac region was less than that in the distal region(P<0.05),while the anastomosis time had no statisti-cal difference(P>0.05).There was no significant difference in the incidence of flap crisis and the outcome of flap repair be-tween two regions(P>0.05).Conclusion:It was found that the main perforators of ALTF show a dumbbell-like symmetrical distribution in the proximal cardiac region to distal cardiac region direction by the analysis based on coordinate positioning method,and the anatomical characteristics between the two regions were statistically significant,which would be helpful for the harvesting of ALTF and the selection of perforators.
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