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. 2023 May 1;90(5):447-450.
doi: 10.1097/SAP.0000000000003523. Epub 2023 Mar 4.

Posterior Circumflex Humeral Artery Perforator Flap: A Cadaveric Study and Case Series

Pietro Garieri  1 , Arianna Gatto, Leonardo Brambilla, Erica Cavalli  1 , Denis Codazzi  2 , Andrea Marchesi  1
Affiliations

Posterior Circumflex Humeral Artery Perforator Flap: A Cadaveric Study and Case Series

Pietro Garieri et al. Ann Plast Surg. .

Abstract

Background: Reconstruction of soft tissue defects of the acromioclavicular region represents a relatively uncommon but challenging event. Many muscular, fasciocutaneous, and perforator flaps have been described, including the posterior circumflex humeral artery perforator (PCHAP) flap based on the direct cutaneous perforator of the PCHA. This study aims to describe a variant of the PCHAP flap, based on a constant musculocutaneous perforator, by means of a cadaveric study and a case series.

Methods: A cadaveric study was conducted using 11 upper limbs. The perforator vessels originating from the PCHA were dissected and the musculocutaneous ones were identified and measured in their length and distance from the deltoid tuberosity. Besides, we retrospectively analyzed the posterior shoulder reconstruction conducted among 2 plastic surgery department (San Gerardo Hospital, Monza and Hospital Papa Giovanni XXIII, Bergamo) using the musculocutaneous perforators of the PCHA.

Results: The cadaver dissection showed the presence of a constant musculocutaneous perforator arising from the PCHA. The mean pedicle length is 6.10 ± 1.18 cm, and the musculocutaneous perforator pierces the fascia at a mean distance of 10.4 ± 2.06 cm from the deltoid tuberosity. In all the cadaver dissected, the perforator of interest divided into 2 terminal branches, anterior and posterior, nourishing the skin paddle.In our case series, the mean age of the patients was 66.7 years, the mean size of the defect was 46 cm 2 , the mean operating time was 79.3 minutes, the mean length of hospital stay was 2.7 days, and the complication rate was 28.6%.

Conclusions: According to this preliminary data, the PCHAP flap based on the musculocutaneous perforator seems to be a reliable alternative in posterior shoulder region reconstruction.

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Conflict of interest statement

Conflicts of interest and sources of funding: none.

References

    1. Gatto A, Parisi P, Brambilla L, et al. Thoracodorsal artery perforator flap, muscle-sparing latissimus dorsi and descending-branch latissimus dorsi: a multicenter retrospective study on early complications and meta-analysis of the literature. J Plast Reconstr Aesthet Surg . 2022;75:3979–3996.
    1. Lee KT, Mun GH. A systematic review of functional donor-site morbidity after latissimus dorsi muscle transfer. Plast Reconstr Surg . 2014;134:303–314.
    1. Roll C, Prantl L, Feser D, et al. Functional donor-site morbidity following (osteo-) fasciocutaneous parascapular flap transfer. Ann Plast Surg . 2007;59:410–414.
    1. Brambilla L, Parisi P, Gatto A, et al. A retrospective comparative analysis of latissimus dorsi (LD) flap versus thoracodorsal artery perforator (TDAP) flap in total breast reconstruction with implants: a pilot study. J Reconstr Microsurg . 2022;38:451–459.
    1. Marchesi A, Amendola F, Garieri P, et al. Wide local excisions and pedicled perforator flaps in hidradenitis suppurativa: a study of quality of life. Ann Plast Surg . 2021;86:201–205.

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