Aim To measure a calibre of radial and ulnar septocutaneous perforators at the anterior forearm, and to count its number in proximal, middle and distal thirds. Methods The study was conducted on 50 fresh amputated forearms (trauma, tumours) in the period between January 2012 and December 2021. Forearms were collected from several hospitals in Belgrade, and analysed at the Institute of Anatomy, Medical School, University of Belgrade, Serbia. Injection of ink-gelatin and fine dissection of autopsy material was performed on 30 forearms, and corrosion method with injecting methyl methacrylate for 3D analysis on the other 20 forearms. Results A mean calibre of septocutaneous perforators on the radial artery was 0.53±0.46 mm (0.2-0.85). Averagely, there were 8.1 radial artery septocutaneous perforators - two perforators on the proximal third, 3.7 on the middle third, and 2.7 on the distal third. The mean calibre of ulnar artery perforators was 0.65±0.35 mm (0.18-1.8). The average number of septocutaneous perforators of the ulnar artery was 5.6; 1.2 on the proximal third, two on the middle third, and 2.2 on distal third. Conclusion Determination of the origin, calibre and spreading directions of the arterial septocutaneous perforators on the anterior forearm provide quantification of data about arborisation of radial and ulnar septocutaneous perforators at the anterior forearm. Clinical relevance of those anatomical data is in defining of safe locations and dimensions of forearm fasciocutaneous flaps in plastic surgery.
Ilic M, Milisavljevic M, Malikovic A, Laketic D, Eric D, Boljanovic J, et al. The superficial palmar branch of the radial artery: a corrosion cast study. Folia Morphol (Warsz. 2018;77:649–6.
Huang JJ, Wu CW, Lam WL, Nguyen DH, Kao HK, Lin CY, et al. Anatomical basis and clinical application of the ulnar forearm free flap for head and neck reconstruction. Laryngoscope. 2012;122:2670–6.
4.
Bell RA, Schneider DS, Wax MK. Superfiatial ulnar artery; a contraindication to radial forearm free tissue transfer. Laryngoscope. 2011;121:933–6.
5.
Hakim SG, Trenkle T, Sieg P, Jacobsen HC. Ulnar artery-based free forearm flap: review of specific anatomic features in 322 cases and related literature. Head Neck. 2014;36:1224–9.
6.
Lane JC, Swan MC, Cassell OC. Closure of the radial forearm donor site using a local hatchet flap: Analysis of 45 consecutive cases. Ann Plast Surg. 2013;70:308–4.
7.
Daya M, Nair V. Free radial forearm flap lip reconstruction: a clinical series and case reports of technical refinements. Ann Plast Surg. 2009;62:361–7.
8.
Kastenbauer E, Tardy EM. Aestetische und Plastische Chirurgie an Nase, Gesicht und Ohrmuschel. 2002.
9.
Rollo G, Luceri F, Pasquino A, Pichierri P, Tomarchio A, Bisaccia M, et al. Bone grafiting combined with Sauvé-Kapandji Procedures for the treatment of aseptic distal radius non-union. J Biol Regul Homeost Agents. 2020;4(Suppl. 3):213–5.
10.
Rollo G, Luceri F, Bisaccia M, Lanzetti RM, Luceri A, Agnoletto M, et al. Allograft versus autograft in forearm aseptic non-union treatment. J Biol Regul Homeost Agents. 2020;34:207–5.
11.
Weinzweig N, Chen L, Chen ZW. The distally based radial forearm fasciosubcutaneous flap with preservation of the radial artery: an anatomic and clinical approach. Plast Reconstr Surg. 1994;94:675–9.
12.
Camuzard O, Foissac R, Clerico C, Fernandez J, Balaguer T, Ihrai T, et al. Inferior cubital artery perforator flap for soft-tissue coverage of the elbow: anatomical study and clinical application. J Bone Joint Surg Am. 2016;98:457–8.
13.
Chang EI, Liu J. Prospective comparison of donor-site morbidity following radial forearm and ulnar artery perforator flap harvest. Plast Reconstr Surg. 2020;145:1267–7.
14.
Mathy JA, Moaveni Z, Tan ST. Perforator anatomy of the ulnar forearm fasciocutaneus flap. J Plast Reconstr Aesthet Surg. 2012;65:1076–5.
15.
Hyuon HH, SCh Y, In BK, Sang HK, Young JJ. A perforator from the ulnar artery and cutaneous nerve of the hypothenararea: An anatomical study for clinical application. Microsurgery. 2017;37:49–6.
16.
Hwang K, Han JY, Chung IH. Hypothenar flap based on a cutaneous perforator branch of the ulnar artery: an anatomic study. J Reconstruction Microsurg. 2005;21:297–4.
17.
Kerr RP, Hanick A, M.A F. Fascia lata free flap reconstruction of limited hard palate defects. Cureus. 2018;21;10:e2356.
18.
Xie RG. Medial versus lateral approach to harvesting of anterolateral thigh flap. J Int Med Res. 2018;46:4569–8.
19.
Altiparmak M. Fasciocutaneus and/or myocutaneus flaps versus perforator flaps: systematic review and meta-analysis for reconstruction of ishial pressure sores. Eur J Plast Surg. 2020;43:211–7.
20.
Raspanti A, Delcroix L, Ghezzi S, Innocenti M. Study of the tendinous vascularization for the compound radial forearm flap plus flexor carpiradialis tendon. Sur Radiol Anat. 2016;38:409–5.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
