Anatomical study of the medial upper arm flap and clinical applications

Objective To investigate the blood supply of the expanded skin flap from medial upper arm.Methods Microsurgical anatomical study was carried out on10 fresh upper limbs of human cadavers,which had been injected with red and blue latex.The study was focused on the origin,numbers,position and vascular anastomosis of perforator artery(diameter≥0.30mm)origiated from brachial artery.Results 8～9 cutaneous arteries are gived off from brachial artery at the layer of the deep fascia,these branches which give off the ramus anastomoticus also tend to anastomose in the deep fascial,superficial fascia and subdermal level respectively,they shape the vascular network on the deep fascia,in the superficial fascia and subdermal level and are the main supplying vessels.More ramus anastomoticus are observed on the medial intermuscular septum,and then posterior part of the arm.There are total 84 cutaneous artery perforators in 10 upper limbs,most of them locate at the medial intermuscular septum.Conclusions The blood supply of the medial upper arm flap is sufficient,branches of the cutaneus artery anastomose along the longitude direct of the intermusular septum,so the flap which is separated on the deep fascia along intermusular septum is safe,if larger flap is needed the flap can be extended to the posterior.Intermusular septum is the better position of the pedicle.