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Objective@#To explore the clinical application value of mixed reality technology in locating perforator vessels and assisting perforator vessel dissection to harvest anterolateral thigh flaps.@*Methods@#Six patients who needed anterolateral thigh flap repair after resection of oral and maxillofacial tumors were recruited from the Department of Oral and Maxillofacial Surgery of Nanchong Central Hospital from January 2020 to January 2021. Before surgery, the CT angiography data of the lower limbs of the patients carrying the calibration points were imported into the data workstation to perform 3D reconstruction of the perforator vessels and surrounding tissues of the thigh, and the reconstruction results were imported into Microsoft HoloLens 2 glasses. During the operation, calibration was performed at the calibration point of the operative area so that the preoperative reconstruction results were superimposed on the operative area through Microsoft HoloLens 2 glasses. The clinical application value of mixed reality technology assisted perforator vessel location and anatomy of anterolateral femoral perforator flap was discussed from six aspects: whether the perforator vessel was reconstructed preoperatively, intraoperative calibration time, whether the actual position of the perforating vessels passing through the fascia lata fulcrum deviated from the preoperative reconstruction result within 1 cm, time required to harvest the flap, and whether the actual route of the perforator vessel was consistent with the reconstruction result, and whether the postoperative flap survived.@*Results @# The position and course of perforating vessels were successfully reconstructed in 6 cases before the operation. The actual course of perforating vessels during the operation was consistent with the reconstruction results. The deviation between the actual position of the perforating points and the preoperative reconstruction results was within 1 cm, which met the requirements of the actual asisting of the anterolateral thigh flap. The average time of flap harvest was (70.50 ± 7.20) min. The average calibration time was (13.33 ± 5.50) min. All flaps survived.@* Conclusions @# Mixed reality technology projects the reconstruction results of anterolateral femoral perforator vessels directly into the operative area, which provides a new method for asisting localization and anatomy of anterolateral femoral flap perforator vessels and reduces the possibility of injury to perforator vessels.
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Objective@#To investigate the design of free perforator flap, and the efficacy of utilizing perforator flaps for Ⅳ degree Ischia-sacral ulcer treatment.@*Methods@#From January 2010 to October 2016, 18 patients with Ⅳ degree ischia-sacral ulcer were treated. The surface area of the sacral tail ranged from 4 cm×5 cm to 8 cm ×12 cm.Doppler sonography was used to detect potential perforator.All defects were repaired with free perforator flaps, designed based on the size and shape of the wound. The flap size ranged from 6 cm×11 cm to 9 cm×15 cm.@*Results@#One perforator flap went dehiscence after surgery, repaired by V-Y flap. All the rest of perforator flaps survived well, after 3-24 months follow-up. Flap texture and appearance was good, no ulcer reoccurred.@*Conclusions@#The free perforator flap is a simple technique.It does not need to tracethe trunk of vessels, and it does not cause major morbidities to the buttocks. Therefore, it is one of the ideal ways to repair Ⅳ degree Ischia-sacral ulcer.
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Objective To provide anatomical basis for the design of the V-Y advancement flap and investigate the morphological characters of the dorsal carpal perforators.Methods From August,2017 to October,2018,30 sides aduh specimens of hand were perfused with red latex.The following contents were observed under surgical magnifier:①The origin,courses,branches,and distribution of the dorsal carpal perforators.②The characters of dorsal carpal perforators in agreement with the antebrachial and dorsal metacarpal vascular net.Results The dorsal carpal vascular network was composed of deep vascular network (bone and joint network) and superficial vascular network (fasciocutaneous network).The deep vascular network was located at the deep aspect of the extensor tendons and was commonly formed by dorsal carpal branch of radial artery,dorsal carpal branch of anterior interosseous artery,ascending branch of the dorsal carpal perforator from the deep palmar arch,and dorsal carpal branch of ulnar artery.The superficial vascular network was located on the surface of the extensor tendons and was mainly formed by dorsal carpal branch of radial artery,dorsal carpal branch of ulnar artery,dorsal carpal branch of anterior interosseous artery,radial and ulnar myocutaneous branches of posterior interosseous artery,and the perforators from the deep vascular network.The 3rd and 4th perforators puncturing out from the ulnar and radial margins of the extensor tendon had a constant occurrence rate (100％) with an outer diameter of (0.7±0.3) mm and (0.6±0.2) mm,respectively,and a length of (1.1±0.4) cm and (0.9±0.4) cm,respectively.They were divided into the ascending branch,descending branch,and collateral branch.And finally anastomosis with antebrachial and dorsal metacarpal perforators.Conclusion The V-Y advancement flap based on the dorsal carpal perforators can be a good choice for restoring the dorsal metacarpal defects.
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Objective@#To explore the clinical application effect of the orbital periorbital perforator flap pedicled with zygomatic artery to repair the defect of eyelid ectropion and the defect after tumor resection.@*Methods@#(1)Perfused 10 fresh cadavers gelatin lead oxidate with one-time arteriography and CT spiral scanning, and imported DICOM data into Mimics 17.0 for rapid body mapping and three-dimensional reconstruction, and observed the source of zygomatic orbital artery and distribution rules of perforating branches. (2)From July 2012 to July 2017, 18 clinical cases were repaired by orbital periorbital perforator flap pedicled with zygomatic artery, the flap was cut with the same width as the defect width, and the length of the flap was 2 to 3 times the defect length, with an area of 0.3 cm × 1.5 cm to 2.0 cm × 3.0 cm.@*Results@#The zygomatic orbital artery originated from the superficial temporal artery, extending up to about the midpoint of the line between the anterior ear and the lateral canthus.The clinical application of the orbital periorbital flap with the perforating branch of the zygomatic orbital artery in 18 cases survived and healed well. After 1 month to 2 years of follow-up, the color, texture and shape function recovered well.@*Conclusions@#The orbital periorbital flap with the perforating branch of the zygomatic orbital artery is a good method for reconstruction of ectropion and palpebral defect due to its reliable movement and the arterial arch connected with the orbicularis suborbicularis.
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Objective: To evaluate the surgical technique and the effectiveness of the free superficial palmar branch of the radial artery flap to repair soft tissue defect of fingers. Methods: Between June 2014 and June 2017, 10 cases (10 fingers) of soft tissue defects of fingers were repaired with the free superficial palmar branch of the radial artery flaps. There were 8 males and 2 females with an average age of 29.8 years (range, 23-42 years). The causes of injury included the chainsaw cutting injury in 6 cases, the machine crush injury in 2 cases, and the glass scratching in 2 cases. The time from injury to admission was 1-8 hours with an average of 3 hours. The locations were the volar of the middle of index finger in 3 cases, the volar of the distal of index finger in 1 case, the volar of the distal of middle finger in 3 cases, the ulnar side of distal interphalangeal joint of ring finger in 1 case, and the volar of the distal of the little finger in 2 cases. The area of soft tissue defect ranged from 1.8 cm×0.9 cm to 2.8 cm×2.1 cm, and the area of flap ranged from 2.0 cm×1.0 cm to 3.0 cm×2.3 cm. The donor sites were sutured directly. Results: All flaps survived after operation, and the wounds healed by first intention. The incisions of donor site also healed by first intention with a linear scar. All cases were followed up 6-12 months (mean, 9 months). The appearance and texture of the flaps were satisfactory. The pain sensation, warm sensation, and touch sensation of the flap recovered. At last follow-up, the two-point discrimination of the flap was 6-13 mm (mean, 7.5 mm). According to the assessment of the upper limb function issued by tha Hand Surgery Society of Chinese Medical Association, the results were graded as excellent in 8 cases and good in 2 cases. Conclusion: The free superficial palmar branch of the radial artery flap is easy to harvest and anastomose and has small injury. It is an ideal method in repairing of soft tissue defects of fingers.
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Objective To evaluate the effects of nasolabial flap with facial artery and its branches perforator for reconstruction of nasal defect.Methods Between March 2013 and April 2017,21 patients underwent operations for the reconstruction of nasal defect,caused by trauma,surface tumors,moles and infection.The size of the defect was 1.5 cm × 2.0 cm to 3.0 cm × 3.0 cm.Designed various nasolabial perforator flap was pedicled with the facial artery.The pulsed blood flow detector determined the location of the facial artery and its perforation position,which was the rotation point,and the rotation of the nasolabial fold flap covered the nasal defect area to repair.Results 21 flaps survived.Surface artery perforation nasolabial fold flap was good blood supply,of which 1 case of flap was congested and recovered after treatment.After 1 month to 3 years follow-up on 21 cases,20 cases showed good results and 1 case had generally accepted.The color,shape and function of the flap were significant,similar to the normal skin.Conclusions A small area defect in the nose is preferred by using facial arterial perforation nasolabial fold flap repair,which does not need secondary repair,and is worthy of clinical application.
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Objective To analysisthe evaluation clinical effects and complications of retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap for the re-pair of the leg and foot skin defect effect. Methods In January 2010 to January 2015,patients with leg and foot skin defect effect in our hospital administrated withperoneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle skin flap were retrospectively analyzed.Flap survival,necrosis rate, the function of the skin flap and complications were analyzed. Results The one stage flap survival rate of peroneal artery group(84.6%)is higher than the posterior tibial artery group(57.69%),the difference was statistically sig-nificant(P 0.05). The occur-rence of hyperplastic scar,itching,pigmentation,skin graft,numbness,skin graft abnormal pain complication rates inperoneal artery group were significantly lower than the posterior tibial artery ,and the difference was statisti-cally significance(P < 0.05). Conclusion Retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap can effectively repair skin and soft tissue defect ,retrograde peroneal artery perforators shows with higher survival rate and less complication.
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Objective To recognize the relationship between high cutantous artery branches and descending branch of lateral femoral circumflex artery artery,and to investigate the blood supply of anterolateral thigh flap in clinical.Methods Retrospective analysis 152 cases of anterolateral thigh flap from November,2003 to December,2016.It contains cutting with descending branchs in 99 cases,cutting with lateral branchs in 43 cases,the union of them in 8 cases and high cutantous artery branches in 2 cases.Results The flaps survival in 147 cases,cutting necrosis in 3 cases and partly necrosis in 2 cases.Descending and lateral branchs were both dominance neurovascular bundle of vastus lateralis muscle,independently or commonly dominate the skin of anterolateral thigh,occurrence rate was 33.5％.Conclusion The descending branch of lateral femoral circumflex artery include lateral branch,all of which are the neurovascular bundles,supply the anterolateral thigh muscle,and divid into some perforator branches crossing the musle to the anterolateral thigh skin subsequently,which constitute "the anatomical functional unit".High cutantous artery branche is the one of all of the branches,its origin lies hight and arise from lateral branch.
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Objective To observe the curative effect of repairing the distal foot skin and soft tissue defect by using flap.Methods We used nutrient artery flap and low external ankle to repair the foot distal skin soft tissue defect in 16 cases.Results The flap survived,necrosis happened in small skin edge part and distal skin flap of sural nerve nutrient artery flap in two cases,and the skin graft healing with dots after removed the necrotic tissue and changed dressing.16 cases were followed up for 3-16 months,2 cases of flap slightly bloated,1 case back to the hospital got thin skin flap repairing technique;14 cases of walking were as usual,2 lame cases,related to some tissue defect in patients with forefoot injury.The use of flap to repair the foot injury,could maximially recover the limb function,reduce the rate of the sick.Conclusion Skin flap is a kind of operation which is simple,with smaller cost for skin area,beautiful and effective to repair skin and soft tissue defect of foot.
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Varicose veins have troubled mankind for thousands of years, and their various treatments and complications have been documented from the times of Hippocrates. Although thrombophlebitis is a relatively common condition in the superficial veins of the upper or lower limbs, it usually follows some intravenous intervention or trauma. Thrombosis followed by thrombophlebitis in varicose veins has seldom been reported in literature but the occurrence of spontaneous thrombosis in only the above knee perforator veins of the lower limb has been seldom mentioned. We report the case of a patient with long standing varicose veins of the left lower limb presenting with spontaneous thrombosis of only the above knee perforators and our subsequent management.
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Objective To introduce a method of using perforators flap adjacent to the defect to repair small sized skin defect.Methods From October 2009 to December 2013,a total of 23 cases of skin lesions were treated with perforators flap adjacent to the defect.The perforator artery was preoperatively detected with Portable Doppler in the region of relative slack skin.Skin defects with the area changed from 1.5 cm × 2.0 cm to 5.0 cm × 4.0 cm.Results All the flap survived smoothly,with pleased appearance and primary healing.Postoperative follow-up of 3 to 6 month showed no recurrence in tumor patients during the follow-up period.Conclusions Application of perforators flap adjacent to defect to repair small sized skin defect has the advantages of flexibility,reliable blood supply,which obtains good result.
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Subject(s)
Humans , Arteries , Canada , Curriculum , France , Glycosaminoglycans , Human Body , Japan , Muscles , Organic Chemicals , Perforator Flap , Skin , Subcutaneous Tissue , Surgery, Oral , Thigh , Tissue DonorsABSTRACT
Objective To observe the anatomic relationship between the lateral sural artery perforators and the nutrient vessels of the lateral sural cutaneous nerve that were combined to design a compound muscle flap.And to observe the effect of this flap clinical application.Methods Ten adult and fresh cadaver lower limbs were observed the anatomic relationship between the lateral sural artery perforators and the nutrient vessels of the lateral sural cutaneous nerve,and were combined to design a compound muscle flap.Clinically applied in 5 cases,and the flap sizes ranged from 6 cm × 9 cm to 9 cm × 12 cm.Results After into the muscle,the lateral sural artery issued 3-5 perforating branches (OD:0.2-1.8 mm) along the way,which provided nutrition for the lateral head of the gastrocnemius and the surrounding skin and involved in the formation of shallow and deep fascia vascular network with the nutrient vessels of the lateral sural cutaneous nerve.From Feburary 2009 to November 2011,the compound pedicled muscle flap were clinically applied in 5 cases to repair the skin defects of the anterior knee and proximal tibia.Flaps in 4 cases completely survivedand 1 case had partial superficial necrosis on the distal part of the flap,which healed after dressing change.Conclusion The compound pedicled muscle flap has two sets of blood supply that could expand the area of the flap,which could guarantee its feeling.This kind of flap could repair the complicated skin and soft tissue defects around the knee joint.
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OBJECTIVES: To study the perforators of the medial sural artery and the possible size of their flap. METHODS: The external iliac arteries of ten adult preserved cadavers (males and females) were injected with a mixture of red latex and lead oxide. The skin was reflected and the medial sural artery and its perforators were identified. The diameters and origins of perforators were measured from the central popliteal crease. RESULTS: The medial sural artery originated from the popliteal artery in 70% and had its external diameter at a mean of 3 ± 0.02 mm and was accompanied by two venae comitantes. The number of its perforators was at a mean of two perforators. Length of the pedicle of the medial sural artery perforator flap was at a mean of 18 ± 0.03 cm. The largest of the perforator had an average external diameter of 0.9 mm. The perforators ramified the skin with branches of the artery accompanying the posterior cutaneous nerve and the perforating branches of the peroneal and the posterior tibial arteries. The possible size of the medial sural perforators flap was at an average 8.2 cm × 13.3 cm. CONCLUSION: The medial sural artery perforator flap has at least one or two perforators with an average size of 8.2 cm × 13.3 cm. Elevation of the flap will not affect the vascularity of the gastrocnemius muscle.
OBJETIVOS: Estudiar los perforantes de la arteria sural medial y el posible tamaño de su colgajo. MÉTODOS: A las arterias ilíacas externas de diez cadáveres adultos preservados (varones y hembras) se les inyectó una mezcla de látex rojo y óxido de plomo. La piel fue reflejada y la arteria sural medial y sus perforantes fueron identificados. Los diámetros y orígenes de los perforantes fueron medidos desde el pliegue poplíteo central. RESULTADOS: La arteria sural medial se originaba partiendo de la arteria poplítea en 70%. Su diámetro externo alcanzaba un valor medio de 3 ± 0.02 mm y estaba acompañada de dos venas comitantes. El número de sus perforantes fue de dos como promedio. La longitud del pedículo de la arteria sural medial tuvo un valor promedio de 18 ± 0.03 cm. El perforante mayor tuvo un diámetro externo promedio de 0.9 mm. Los perforantes ramificaron la piel con ramas de la arteria que acompaña el nervio cutáneo posterior, y las ramas perforantes de las arterias tibiales posteriores y fibulares o peroneas. El tamaño posible del colgajo perforante sural medial tuvo un valor promedio de 8.2 cm × 13.3 cm. CONCLUSIÓN: El colgajo perforante de la arteria sural medial posee al menos uno o dos perforantes con un tamaño promedio de 8.2 cm × 13.3 cm. La elevación del colgajo no afecta la vascularidad del músculo gastrocnemio.
Subject(s)
Female , Humans , Male , Arteries/anatomy & histology , Lower Extremity/blood supply , Surgical Flaps/blood supply , Cadaver , Popliteal Artery/anatomy & histologyABSTRACT
Objective To provide anatomical basis for the thigh medial neurocutaneous vascular flap pedicled with descending genicular artery perforators. Methods ① The course and distribution of thigh medial cutaneous nerve. ②Anastomosis between descending genicular artery perforators and thigh medial neurocutaneous vascular, were observed on 40 specimens of adult lower limb perfused with red latex. Mimic operation was performed on one side of fresh specimen. Results ①The line between the midpoint of inguinal ligament and medial femoral condyle can be considered as the projection on body surface of thigh medial cutaneous nerve. ②Perforating branches of descending genicular artery (infrapatellar branch )started from the lower edge of medial femoral condyle about 4 cm, and passed through the deep fascia in which the triangle depression surrounded by the vastus medialis muscle, adductor tendon and the medial femoral condyle to the subcutaneous. They also separated large number of small blood vessels, which closely aligned with the perineural and neural stem vascular chain of thigh medial cutaneous nerve. Then they formated vascular plexus in the upper part of thigh along the thigh medial cutaneous nerve longitudinal axis. Conclusion The thigh medial neurocutaneous vascular flap pedicled with descending genicular artery perforators can be formed to repair soft tissue defect around knee joint.
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INTRODUÇÃO: O retalho ântero-lateral da coxa é baseado em vasos perfurantes do ramo descendente da artéria circunflexa lateral femoral. Este retalho tem características muito interessantes para a cirurgia reparadora, como a pequena espessura, pedículo longo e excelente área doadora. No entanto, existem muitas controvérsias na literatura quanto aos vasos perfurantes e ao trajeto do pedículo deste retalho. Neste trabalho procurou-se estabelecer alguns parâmetros anatômicos e esclarecer estas controvérsias. MÉTODO: Estudaram-se 100 coxas de 50 cadáveres quanto aos seguintes aspectos: 1- Número e localização de perfurantes encontrados, 2- Trajeto do pedículo perfurante, 3- Trajetória intramuscular, 4- Comprimento do trajeto intramuscular, 5- Comprimento total do pedículo, 6- Diâmetro dos vasos e 7- Espessura do retalho. RESULTADOS: 1- Encontraram-se de 0 a 4 perfurantes por coxa estudada, todas em um raio de até 6cm do ponto médio entre a espinha ilíaca ântero-superior e a borda lateral da patela. 2- Os vasos perfurantes tinham trajeto músculo-cutâneo em 75,76% das coxas e septo-cutâneo em 24,24%. 3- Dos pedículos perfurantes com trajeto músculo-cutâneo, 86,67% possuíam trajetória indireta contra 13,33% com trajetória direta. 4- O comprimento médio do trajeto intramuscular dos pedículos foi de 3,67 ± 2,01 cm. 5- O comprimento médio do pedículo total foi de 11,31 ± 3,12 cm. 6- O diâmetro médio da artéria na origem do ramo descendente da artéria circunflexa femoral foi de 2,21 ± 0,85 mm e para as veias no mesmo local de 2,66 ± 1,33 mm e 2,10 ± 1,11 mm. 7- A espessura da tela subcutânea foi de 8,98 ±6,23 mm e da pele de 1,60 ± 0,76 mm. CONCLUSÕES: 1- Existiu uma pequena possibilidade de não haver pedículos perfurantes. 2- Quando presentes, os pedículos perfurantes do ramo descendente da artéria circunflexa lateral femoral eram encontrados em numero de 1 a 4, sempre em um raio de 6 cm a partir do ponto médio entre a espinha ilíaca ântero-superior e a borda...
INTRODUCTION: The anterolateral thigh flap is based on the perforator vessels of the descending branch of the lateral circumflex femoral artery. This flap has very interesting characteristics for the reconstructive surgery, like the small thickness, long pedicle and excellent donor site. On the other hand, there are many controversial data on the literature about the perforator vessels and the pedicle course of this flap. The aims of this study are to establish some anatomical parameters and clear some controversies. METHOD: A hundred thighs of 50 cadavers were studied for: 1- The number and location of the perforator vessels. 2- The course of the perforator pedicles. 3- The intramuscular course. 4- The length of the intramuscular course. 5- The total length of the vascular pedicle. 6- The diameter of the vessels. and 7- The thickness of the flap. RESULTS: 1- There were found from 0 to 4 perforators per thigh, all in a 6cm radius from the mid point between the anterosuperior iliac spine and the lateral border of the patella. 2- The pedicles was musculocutaneous in 75,76% of the thighs and septocutaneous in 24,24%. 3- Among the musculocutaneous pedicles, 86,67% had a direct intramuscular course, and 13,33% had indirect course. 4- The mean length of the intramuscular course was 3,67 ± 2,01 cm. 5- The mean total pedicle length was 11,31 ± 3,12 cm. 6-The mean artery diameter on the origin of the descending branch of the lateral circumflex femoral artery was 2,21 ± 0,85 mm and the mean vein diameter on the same spot was 2,66 ±1,33 mm and 2,10 ± 1,11 mm. 7- The mean subcutaneous fat tissue thickness was 8,98 ± 6,23 mm and the mean skin thickness was e 1,60 ± 0,76 mm. CONCLUSIONS: 1- There was a possibility of finding no perforators of the descending branch of the lateral circumflex femoral artery. 2- When present, the perforators pedicles were found in numbers between 1 to 4, always in a 6cm radius from the mid point between the anterosuperior iliac spine...
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Male , Female , Adult , Middle Aged , Aged, 80 and over , Cadaver , Hip/anatomy & histology , Hip/blood supply , Microsurgery , Surgical Flaps/statistics & numerical data , Surgical Flaps/blood supply , Surgical Flaps , Surgery, PlasticABSTRACT
A case with a true posterior communicating artery aneurysm is reported, who had been managed by early surgical neck clipping and post-operative intensive cares for numerous complications. The small saccular aneurysm was located at the proximal posterior communicating artery and directed superiorly. A lacunar infarct developed at right anterior thalamus post-operatively, which had resulted probably from the occlusion of a fine posterior communicating arterial perforator. Aneurysms of the posterior communicating artery itself are saccular or fusiform. Great cares should be taken in surgical aneurysmal neck clipping to avoid any injury of the perforators and the oculomotor nerve;trapping of the posterior communicating artery to treat fusiform or wide-necked aneurysms will result in unpredictable outcomes.
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Aneurysm , Arteries , Intracranial Aneurysm , Neck , Stroke, Lacunar , ThalamusABSTRACT
The detailed knowledge of the microvascular anatomy and the recognition of the anatomical variations of the middle cerebral artery (MCA) are very important for neurosurgeons to construct a better and safer microdissection plan and to prevent postoperative neurological deficits. This paper mainly reviewed segments, perforators, cortical arteries, branching patterns, anomalies, and regional anatomy relating various neurovascular surgery such as vascular anastomosis and the management of aneurysms and arteriovenous malformations of the MCA.
Subject(s)
Anatomy, Regional , Aneurysm , Arteries , Arteriovenous Malformations , Microdissection , Middle Cerebral ArteryABSTRACT
The detailed knowledge of the microvascular anatomy and the recognition of the anatomical variations of the middle cerebral artery (MCA) are very important for neurosurgeons to construct a better and safer microdissection plan and to prevent postoperative neurological deficits. This paper mainly reviewed segments, perforators, cortical arteries, branching patterns, anomalies, and regional anatomy relating various neurovascular surgery such as vascular anastomosis and the management of aneurysms and arteriovenous malformations of the MCA.
Subject(s)
Anatomy, Regional , Aneurysm , Arteries , Arteriovenous Malformations , Microdissection , Middle Cerebral ArteryABSTRACT
Objective To investigate a new method of improving design of the skin flap pedicled with descending hranch of lateral femoral circumflex artery,in order to increase the accuracy of preoperative Doppler location.Methods Six fresh cadavers underwent a whole body,intra-arterial injection of a lead ox- ide and gelatine preparation.Observe the perforators of anterolateral thigh by dissection,measured their diam- eter;course,branches and location for there were showed up by angiography and photography.A specific pro- gram,3D-doctor,was used for the detection of the regions of interest in angisome and its 3D-reconstructive.In addition to the average area supplied by a single perforator within that territory was calculated from digital an- giograms using Scion Image.Results There were 16 perforators that the diameter≥0.5 ram,20%were septocutaneous,80%were musculocutaneous.Their average external diameter was 0.8 ram.The average ped- icle length from the deep fascia was(3.15?1.43)ram;the perforators from descending branch of lateral cir- cumflex femoral artery walk length average about 2.63 cm in superficial fascia.The area of each perforator supplied blood was average 45.61 cm~2.Conclusion Modified lead oxid-gelatine technique provides high quality angiograms for the study of cutaneous artery and perforator falp.Based on our data,the maximum di- mension of the anterolateral thigh perforator flap can be 30 cm?20 cm in with only a single dominant perfora- tor.The perforator flaps deviced by perforators from the anterolateral thigh are transplanted to the lower limbs and the other part of the body.