[The applied anatomy of axial subdermal vascular network skin flap and its application in the management of deep burn wound]

Abstract

Objective: To explore the anatomical basis and clinical application of axial subdermal vascular network skin flap (ASVNF) in the management of deep burn wounds.

Methods: Twelve samples of skin and subcutaneous tissue of lower extremities from adult cadavers were anatomically observed. The course, branching and the architecture of the subdermal vascular network (SVN) in the superficial facia and the ultra-thin area of the anterolateral femoral and saphenous axial subdermal vascular network skin flaps were intensively studied. The wounds in twenty-six patients with deep burn injury in the limbs were repaired with ASVNF.

Results: The circular thinning method was employed in the preparation of anterolateral femoral ASVNF whose blood supply was provided by the musculocutaneous perforators. And the "U" shaped ultra-thin method was employed in the preparation of saphenous ASVNF, whose blood supply was directly provided by skin vessels. The flaps in these 26 patients survived very well in terms of the flap color, texture, contour and function after followed-up for 0.5 approximately 2.5 year.

Conclusion: Thinning methods for different kinds of ASVNF should be individualized. ASVNF might be an optimal choice in the management of deep burn wounds due to its obvious advantages.