Fasciocutaneous vessels. Their distribution on the trunk and limbs, and their clinical application in tissue transfer

Abstract

In the conventional view of the arterial blood supply of skin, two systems of vessels are recognised; the direct cutaneous arteries and the musculocutaneous perforators. The existence of a third system consisting of fasciocutaneous perforators, is a relatively new concept. These vessels supply the skin by passing along the fascial septa between adjacent muscles. A particular feature of these fasciocutaneous perforators is that they spread out at the level of the deep fascia, forming a fascial plexus which often has a marked directionality. The locations of these perforators and the axiality of the fascial plexi are described. This knowledge is important for the elevation of pedicled fasciocutaneous flaps and the design of fasciocutaneous microvascular free tissue transfers.