open access

Ahead of Print
Review article
Submitted: 2021-09-06
Accepted: 2021-10-13
Published online: 2021-10-26
Get Citation

Anatomical variations of the vascular supply of the cutaneous component of the serratus anterior myocutaneous flap: a systematic review

C. Gakis1, D. Chrysikos1, A. Samolis1, V. Protogerou1, G. Tsourouflis1, T. Troupis1
DOI: 10.5603/FM.a2021.0111
·
Pubmed: 34699050
Affiliations
  1. Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Greece

open access

Ahead of Print
REVIEW ARTICLES
Submitted: 2021-09-06
Accepted: 2021-10-13
Published online: 2021-10-26

Abstract

Although appealing from a reconstructive standpoint, the incorporation of the overlying skin in a serratus anterior muscle flap has not yet seen widespread use, due to considerations with its blood supply. In the present study, a systematic review of the literature has been performed, evaluating studies that investigated the vascular anatomy and variations of serratus anterior myocutaneous flap. The anatomy of the cutaneous blood supply, the size of the cutaneous territory, the design of the skin paddle and the reconstructive goals were analyzed. The results showed that the main blood supply originates from the intramuscular anastomoses between intercostal artery perforators and the serratus artery branch in the form of choke vessels. Complementary perfusion from true intramuscular vessel anastomoses or from direct serratus artery cutaneous perforators could contribute to the skin blood supply but only in 25% of the cases. The design of the flap is elliptical with its long axis over the harvested muscle slips and maximum width is approximately 6-8 cm. Α myocutaneous serratus anterior flap could be applied in a variety of reconstructive fields, most commonly for head and neck defects. A delay procedure would considerably enhance the perfusion of the cutaneous component and improve the overall viability of the flap.

Abstract

Although appealing from a reconstructive standpoint, the incorporation of the overlying skin in a serratus anterior muscle flap has not yet seen widespread use, due to considerations with its blood supply. In the present study, a systematic review of the literature has been performed, evaluating studies that investigated the vascular anatomy and variations of serratus anterior myocutaneous flap. The anatomy of the cutaneous blood supply, the size of the cutaneous territory, the design of the skin paddle and the reconstructive goals were analyzed. The results showed that the main blood supply originates from the intramuscular anastomoses between intercostal artery perforators and the serratus artery branch in the form of choke vessels. Complementary perfusion from true intramuscular vessel anastomoses or from direct serratus artery cutaneous perforators could contribute to the skin blood supply but only in 25% of the cases. The design of the flap is elliptical with its long axis over the harvested muscle slips and maximum width is approximately 6-8 cm. Α myocutaneous serratus anterior flap could be applied in a variety of reconstructive fields, most commonly for head and neck defects. A delay procedure would considerably enhance the perfusion of the cutaneous component and improve the overall viability of the flap.

Get Citation

Keywords

serratus anterior, flap skin, cutaneous component, blood supply

About this article
Title

Anatomical variations of the vascular supply of the cutaneous component of the serratus anterior myocutaneous flap: a systematic review

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Review article

Published online

2021-10-26

Page views

373

Article views/downloads

166

DOI

10.5603/FM.a2021.0111

Pubmed

34699050

Keywords

serratus anterior
flap skin
cutaneous component
blood supply

Authors

C. Gakis
D. Chrysikos
A. Samolis
V. Protogerou
G. Tsourouflis
T. Troupis

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl