The repair of leg skin defect by the retrograde sartorius myocutaneous flap:clinical anatomy

Objective To provide anatomic basis for repairing leg skin defects by the retrograde sartorius myocutaneous flap.Methods The origin,course,diameter,distribution and anastomosis of sartorius's arteries were explored in 40 cadaveric lower limb specimens.Arteriographies were made in 4 sides of fresh specimens to study the arterial anastomosis in sartorius.Results Nutrient arteries of sartorius represented segmental distribution,including 6～7 branches.The arterial branches in the proximal 1/5 of sartorius came from superficial ilium circumflex artery,lateral femoral circumflex artery or deep femoral artery,in the middle 2/5 from femoral artery,and in the distal 2/5 from saphenous artery,respectively.The diameter of saphenous artery at the origin was about(1.5±0.2)mm,which was near the proximal level of adductor tubercle about(10.2±1.0) cm,and gave rise to 3～5 branches before reaching into sartorius.The terminal branches of saphenous artery composed an arterial network around knee joint below and inside the knee joint.Segmental arteries entered into sartorius and passed along it's vertical axis with 4～7 branches.Link-pattern arterial anastomosises were formed by branches of adjacent vascular pedicles.The diameter was about 0.3 mm at anastomosis point.Cutaneous arteries and musculocutaneous arteries above deep fascia formed interlocking arterial anastomosis net which provided blood supply for the skin on sartorius.Conclusions Interlocking arterial anastomosises in sartorius provide blood supply for retrograde sartorius myocutaneous flap,and enlarge its cutting length.Retrograde sartorius myocutaneous flap pedicled with saphenous artery can be used to repair soft tissue defect of the middle and distal legs.