Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024;13(2):74-76.
doi: 10.61186/wjps.13.2.74.

Artesian Perforator Concept

Ankur Khajuria  1   2 , Isao Koshima  3 , Benjamin Fink  2 , Yutong Zou  2 , Dinithi Liyanage  4 , Francesca Ruccia  2 , Ruben Y Kannan  2
Affiliations
Case Reports

Artesian Perforator Concept

Ankur Khajuria et al. World J Plast Surg. 2024.

Abstract

In this article, we describe the 'Artesian Perforator Concept', based on the idea that in clinical practice, there are multiple plexuses between perforasomes in addition to the supra-fascial direct and indirect linking vessels that are present within deeper soft tissue, which form part of a deeper vascular reservoir, the equivalent of a vascular 'aquifer'. We then demonstrate the use of this concept clinically for a 45-year-old male patient with median sternotomy wound dehiscence who was reconstructed using the Internal Mammary Artery Perforator and Lateral Thoracic Artery Perforator flaps.

Keywords: Artesian Perforator Concept; Internal Mammary Artery Perforator flap; Lateral thoracic artery; Perforasomes; Soft tissue reconstruction; Vascular reservoir.

PubMed Disclaimer

Conflict of interest statement

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. No funding was sought or received for this work.

Figures

Fig. 1
Fig. 1
Eight months post-op image of the IMAP flap based on the lateral thoracic vessel, being perfused via the vascular aquifer.
Figure 2 (a-c)
Figure 2 (a-c)
Schematic illustration showing the evolution of the perforasome from normality (left image) to the development of a vascular aquifer following the division of the source vessel with the enlargement of both direct and indirect linking vessels (center image) and the elevation of a viable aquifer perforator flap (right image).
See this image and copyright information in PMC

References

    1. Saint-Cyr M, Wong C, Schaverien M, Mojallal A, Rohrich RJ. The perforasome theory: vascular anatomy and clinical implications. Plast Reconstr Surg. 2009 Nov;124(5):1529–44. - PubMed
    1. Kannan RY. The internal mammary artery perforator flap and its subtypes in the reconstruction of median sternotomy wounds. J Thorac Cardiovasc Surg. 2016 Jul;152(1):264–68. - PubMed
    1. Yu P, Roblin P, Chevray P. Internal mammary artery perforator flap (IMAP) for tracheostoma reconstruction. Head & Neck. 2006;28(8):723–9. - PubMed
    1. Lecours C, Saint-Cyr M, Wong C, Bernier C, Mailhot E, Tardif M, Chollet A. Freestyle pedicle perforator flaps: clinical results and vascular anatomy. Plast Reconstr Surg. 2010 Nov;126(5):1589–603. - PubMed
    1. Wong C, Saint-Cyr M, Rasko Y, Mojallal A, Bailey S, Myers S, Rohrich RJ. Three- and four-dimensional arterial and venous perforasomes of the internal mammary artery perforator flap. Plast Reconstr Surg. 2009 Dec;124(6):1759–69. - PubMed

Publication types

LinkOut - more resources