This paper is only available as a PDF. To read, Please Download here.
Summary
The neurocutaneous island flap is an axial flap composed of one vein and one nerve, the arterial vascularisation of which is provided by the vascular plexus around and inside the nerve. The vascularisation of the lateral and medial cutaneous nerve of the forearm was studied in twenty fresh human upper limbs.
In ten rats the vascularisation of these nerves was studied using latex injection and in twenty other animals neurocutaneous island flaps were raised based on the lateral forelimb cutaneous nerve and the medial cutaneous nerves of the forelimb.
There was always a consistent arterial longitudinal plexus along the human and animal nerves, which linked the cutaneous perforating arteries. All the experimental flaps harvested survived well.
On the basis of these anatomical and experimental findings neurocutaneous island flaps were raised on the forearms of three patients and are reported on.
References
- Etude anatomique sur les vaisseaux sanguins des nerfs.Arch Neurol. 1892; 67 (XXIII): 1-33
- Les artères de la peau.Masson, Paris1936
- Vascularisation des nerfs radial et cubital au dos de la main. A propos des lambeaux cutanés neuroveineux.Seance de la SociétéAnatomique de Paris, ParisMay, 1991
- Radial and ulnar nerve vascularization in the hand. Anatomical basis of neurocutaneous flap.Surg Radiol Anat. 1992; 14: 87-88
- Neurocutaneous island flaps in the hand. Anatomical basis and preliminary results.Br J Plast Surg. 1992; 45: 586-590
- The upper arm flap.J Microsurg. 1979; 1: 162-169
- Free transfer of forearm flap. Report of 56 cases.Nat Med J China. 1981; 61: 139-147
- The lateral upper arm flap.in: 7th Symposium of International Society of Microsurgery, New York1983
- Ulnar forearm free flap.Br J Plast Surg. 1984; 37: 486-492
- The anatomic basis of fasciocutaneous flap of the posterior interosseous artery.Surg Radiol Anat. 1986; 8: 209-214
- Surgical anatomy of the musculocutaneous nerve. A photographic essay.J Reconstruct Microsurg. 1985; 1: 291-297
- Le nerf brachial cutanéinterne et son accessoire.in: Alnot JY Narakas A Les paralysies du plexus brachial. No 15 GEM monograph series. Expansion Scientifique Française, Paris1989
- Surgical anatomy of the medial antebrachial cutaneous nerve.J Hand Surg. 1989; 14A: 267-273
- On the blood supply of the nerves of the upper extremity.Act Morphol Cad Scient Hung. 1952; 2: 1-10
- The anatomy of free vascularised nerve grafts.Clin Plast Surg. 1984; 11: 101-116
- Human Embryology and Morphology.6th ed. 1949 (London)
- The free transfer of skin flaps by microvascular anastomoses. An experimental study and a reappraisal.Plast Reconstruct Surg. 1973; 52: 16-31
- Blood supply of the nerves of the upper limb in man.Arch Neurol Psychiat. 1945; 53: 91-115
- Die Arterien der Intervertebral-ganglion und der Cerebrospinalnerven des Menschen.Internat Monatschr F Anat U Physiol. 1898; 15: 353
- Cited by: Poirier P. Charpy A)2nd ed. Traitéd'Anatomie Humaine. 3. Masson, Paris1909: 633 (
- Gunshot injuries to blood vessels.Bristol J. Wright & Sons, London1919
- The antecubital fasciocutaneous flap.Br J Plast Surg. 1983; 36: 428-432
- The fasciocutaneous flap: its use in soft tissue defects of the lower leg.Br J Plast Surg. 1981; 34: 215-220
- Vascularization of lateral and medial cutaneous nerves of the forearm. Anatomic basis of neurocutaneous island flap on the elbow.Sur Radiol Anat. 1991; 13: 345-346
Article info
Publication history
Accepted:
March 16,
1993
Received:
August 12,
1991
Identification
Copyright
© 1993 The British Association of Plastic Surgeons. Published by Elsevier Inc.